MEDICARE: DAVID ESTRADA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	37639	CA

General Provider Information

NPI Number	:	1124961875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID ESTRADA

Provider Business Mailing Address
First Line	:	4741 SAINT NICHOLAS AVE
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-4229
Country	:	US
Telephone Number	:	213-605-1437
Fax Number	:

Provider Business Practice Location Address
First Line	:	4741 SAINT NICHOLAS AVE
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-4229
Country	:	US
Telephone Number	:	213-605-1437
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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Directions to “ DAVID ESTRADA ” Practice Location

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