Provider Demographics
NPI:1689408916
Name:ESTRADA, LUKESHA
Entity type:Individual
Prefix:
First Name:LUKESHA
Middle Name:
Last Name:ESTRADA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1962 DWARF STAR DR APT 1037
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89115-6245
Mailing Address - Country:US
Mailing Address - Phone:702-350-6714
Mailing Address - Fax:
Practice Address - Street 1:1962 DWARF STAR DR APT 1037
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89115-6245
Practice Address - Country:US
Practice Address - Phone:702-350-6714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician