Healthcare Provider Details

I. General information

NPI: 1619868866
Provider Name (Legal Business Name): ERIKA BODOH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 N 3RD ST
CAMPBELL CA
95008-2086
US

IV. Provider business mailing address

3528 CALICO AVE
SAN JOSE CA
95124-2535
US

V. Phone/Fax

Practice location:
  • Phone: 408-364-4200
  • Fax: 408-341-7280
Mailing address:
  • Phone: 408-669-9039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number6839072DC2
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: