MEDICARE: ERICA LOUISE SWICK HHP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	21002	CA

General Provider Information

NPI Number	:	1003425539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA LOUISE SWICK HHP

Provider Business Mailing Address
First Line	:	314 HILLTOP DR
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91910-3141
Country	:	US
Telephone Number	:	619-665-8384
Fax Number	:

Provider Business Practice Location Address
First Line	:	8312 LAKE MURRAY BLVD STE O
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92119-3435
Country	:	US
Telephone Number	:	619-333-8384
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2020
Last Update Date	:	07/30/2020

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