Provider Demographics
NPI:1265976021
Name:ESTRELLA, SOL ENRIQUEZ (FNP-BC)
Entity type:Individual
Prefix:
First Name:SOL
Middle Name:ENRIQUEZ
Last Name:ESTRELLA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:SOL
Other - Middle Name:HERMOSO
Other - Last Name:ENRIQUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:21175 CRANBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-5809
Mailing Address - Country:US
Mailing Address - Phone:714-721-1530
Mailing Address - Fax:
Practice Address - Street 1:17612 17TH ST STE 101
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-1962
Practice Address - Country:US
Practice Address - Phone:714-243-5450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-13
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95005215363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily