Healthcare Provider Details

I. General information

NPI: 1891543088
Provider Name (Legal Business Name): ERIKA KIRSTEN ZEEN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ERIKA KIRSTEN NICHOLS

II. Dates (important events)

Enumeration Date: 05/11/2024
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S FREMONT AVE UNIT 7
ALHAMBRA CA
91803-8897
US

IV. Provider business mailing address

296 E 19TH ST
COSTA MESA CA
92627-2834
US

V. Phone/Fax

Practice location:
  • Phone: 626-457-4240
  • Fax:
Mailing address:
  • Phone: 909-801-1391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA68547
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: