Provider Demographics
NPI:1487305264
Name:ESTRELLA, ELVIA (EDD, MSW)
Entity type:Individual
Prefix:DR
First Name:ELVIA
Middle Name:
Last Name:ESTRELLA
Suffix:
Gender:F
Credentials:EDD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 881155
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92168-1155
Mailing Address - Country:US
Mailing Address - Phone:619-656-2202
Mailing Address - Fax:
Practice Address - Street 1:1130 FIFTH AVE
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-2812
Practice Address - Country:US
Practice Address - Phone:619-407-4933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-13
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YS0200X
CA1063731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool