Provider Demographics
NPI:1972762177
Name:ESTRADA, ANA E (PTA)
Entity type:Individual
Prefix:MRS
First Name:ANA
Middle Name:E
Last Name:ESTRADA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 S TORREY PINES DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-2999
Mailing Address - Country:US
Mailing Address - Phone:702-871-0005
Mailing Address - Fax:
Practice Address - Street 1:1701 S TORREY PINES DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-2999
Practice Address - Country:US
Practice Address - Phone:702-871-0005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA0404225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant