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NPI Code Detail

MEDICARE: ERICA AVALOS NP-C

MEDICARE: ERICA AVALOS NP-C
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
1363LP2300XPrimary Care Nurse Practitioner95026106CA

General Provider Information

NPI Number : 1922837624
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA AVALOS NP-C
Provider Business Mailing Address
First Line : 15082 CAPETOWN LN
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92647-2445
Country : US
Telephone Number : 714-797-9908
Fax Number :
Provider Business Practice Location Address
First Line : 2898 LINDEN AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90806-1627
Country : US
Telephone Number : 562-595-8671
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2024
Last Update Date : 07/31/2024

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