Healthcare Provider Details

I. General information

NPI: 1881694198
Provider Name (Legal Business Name): ERIKA BRUCE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 DWIGHT WAY SUITE # 1363
BERKELEY CA
94704-2608
US

IV. Provider business mailing address

955 RAMONA WAY
SAN LEANDRO CA
94577-3726
US

V. Phone/Fax

Practice location:
  • Phone: 510-204-4666
  • Fax: 510-204-5304
Mailing address:
  • Phone: 510-382-1844
  • Fax: 510-383-9775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number249444
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: