Provider Demographics
NPI:1699915710
Name:ESTRADA, WENDY
Entity type:Individual
Prefix:MS
First Name:WENDY
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 1:14067 ASTORIA ST
Mailing Address - Street 2:209
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-2836
Mailing Address - Country:US
Mailing Address - Phone:818-355-3873
Mailing Address - Fax:
Practice Address - Street 1:14067 ASTORIA ST
Practice Address - Street 2:209
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-2836
Practice Address - Country:US
Practice Address - Phone:818-355-3873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner