Healthcare Provider Details

I. General information

NPI: 1447096300
Provider Name (Legal Business Name): DENISE ESTRIDGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2024
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 EUREKA RD
ROSEVILLE CA
95661-3027
US

IV. Provider business mailing address

928 VALLEJO WAY
SACRAMENTO CA
95818-2155
US

V. Phone/Fax

Practice location:
  • Phone: 916-484-4000
  • Fax:
Mailing address:
  • Phone: 916-300-5268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: