Individual
MS. TANIA ESTRADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYCH TECH LICENSE
Contact information
Practice address
1126 N GRAND AVE, COVINA, CA 91724-1551
(562) 781-4041
Mailing address
16845 SAN BERNARDINO AVE APT 10, FONTANA, CA 92335-9225
(909) 319-5525
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT 36114
CA
Other
Enumeration date
10/03/2013
Last updated
11/17/2014
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