Individual
ELVIA ADRIANA BALTAZAR ESTRADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15305 RAYEN ST, NORTH HILLS, CA 91343-5117
(818) 892-3423
Mailing address
15305 RAYEN ST, NORTH HILLS, CA 91343-5117
(818) 892-3423
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
172V00000X
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-2633765
MEDI-CAL
CA
Enumeration date
02/27/2024
Last updated
02/27/2024
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