Healthcare Provider Details

I. General information

NPI: 1467339994
Provider Name (Legal Business Name): NAOMI LORRAINE ESTRADA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 W EL CAMINO ST
SANTA MARIA CA
93458-3611
US

IV. Provider business mailing address

430 MOUNTAIN AVE STE 304
NEW PROVIDENCE NJ
07974-2731
US

V. Phone/Fax

Practice location:
  • Phone: 805-316-9813
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: