Healthcare Provider Details

I. General information

NPI: 1568850253
Provider Name (Legal Business Name): CHERRELYN ESTELL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHERRELYN ESTELL - HIGGINS NP

II. Dates (important events)

Enumeration Date: 01/02/2015
Last Update Date: 03/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7451 LANKERSHIM BLVD
NORTH HOLLYWOOD CA
91605-2803
US

IV. Provider business mailing address

PO BOX 92944
PASADENA CA
91109
US

V. Phone/Fax

Practice location:
  • Phone: 818-765-5400
  • Fax: 818-765-5402
Mailing address:
  • Phone: 626-399-6777
  • Fax: 800-456-7698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95005778
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95005778
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95005778
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number66328
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number95048955
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number95048955
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number66328
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: