Healthcare Provider Details

I. General information

NPI: 1376434944
Provider Name (Legal Business Name): ESTRELLA LOZANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2025
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 W BOUTZ RD
LAS CRUCES NM
88005-3118
US

IV. Provider business mailing address

PO BOX 510
DONA ANA NM
88032-0510
US

V. Phone/Fax

Practice location:
  • Phone: 575-523-5222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: