Provider Demographics
NPI:1851134522
Name:LINDSAY ESTRADA, LICENSED MARRIAGE & FAMILY THERAPIST INC
Entity type:Organization
Organization Name:LINDSAY ESTRADA, LICENSED MARRIAGE & FAMILY THERAPIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:ESTRADA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:323-458-5756
Mailing Address - Street 1:5478 WILSHIRE BLVD STE 223
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-4225
Mailing Address - Country:US
Mailing Address - Phone:323-458-5756
Mailing Address - Fax:
Practice Address - Street 1:5478 WILSHIRE BLVD STE 223
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4225
Practice Address - Country:US
Practice Address - Phone:323-458-5756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-18
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1134600596Medicaid