Healthcare Provider Details

I. General information

NPI: 1700713294
Provider Name (Legal Business Name): ELIZABETH ASTORGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4952 N 166TH PLZ APT A101
OMAHA NE
68116-3779
US

IV. Provider business mailing address

4805 N 72ND ST
OMAHA NE
68134-2304
US

V. Phone/Fax

Practice location:
  • Phone: 858-366-8590
  • Fax: 858-366-8590
Mailing address:
  • Phone: 402-571-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: