Provider Demographics
NPI:1215698675
Name:ESTRA HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:ESTRA HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MA VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCARDA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:323-338-6101
Mailing Address - Street 1:8612 COPPER KNOLL AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7649
Mailing Address - Country:US
Mailing Address - Phone:323-338-6101
Mailing Address - Fax:
Practice Address - Street 1:1330 KAREN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-1260
Practice Address - Country:US
Practice Address - Phone:725-502-7699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty