Provider Demographics
NPI:1720853161
Name:ESTEVEZ, CRISTA (MA)
Entity type:Individual
Prefix:
First Name:CRISTA
Middle Name:
Last Name:ESTEVEZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7260 W AZURE DR # 140-1012
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-7999
Mailing Address - Country:US
Mailing Address - Phone:702-741-0164
Mailing Address - Fax:
Practice Address - Street 1:4738 MARNELL DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-6940
Practice Address - Country:US
Practice Address - Phone:818-447-9381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker