Provider Demographics
NPI:1316657885
Name:ESTRADA, JULISA
Entity type:Individual
Prefix:MRS
First Name:JULISA
Middle Name:
Last Name:ESTRADA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1285 TRIPP AVE APT 20
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1031
Mailing Address - Country:US
Mailing Address - Phone:408-903-5113
Mailing Address - Fax:
Practice Address - Street 1:1285 TRIPP AVE APT 20
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1031
Practice Address - Country:US
Practice Address - Phone:408-903-5113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-25
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care