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General NPI Number Information
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NPI Number | 1073447132
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Entity Type | Individual
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Provider Name | DANA KATHLEEN ELLAZAR ESTIPONA
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Gender | Female
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Dates
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Enumeration Date | 06/11/2026
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Last Update Date | 06/11/2026
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Provider Practice Location Address
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Address Line | 4850 UNION AVE
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City | SAN JOSE
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State | CA
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Zip | 95124-5156
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Country | US
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Telephone | 800-913-2615
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Fax |
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Provider Business Mailing Address
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Address Line | 750 ALMA LANE STE 100, #4012
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City | FOSTER CITY
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State | CA
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Zip | 94404
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Country | US
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Telephone | 341-204-0539
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 148925
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License Number State | CA
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