Healthcare Provider Details

I. General information

NPI: 1124207923
Provider Name (Legal Business Name): ERIN JEAN CONNAUGHTON PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2007
Last Update Date: 09/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 GOODRICH BLVD
COMMERCE CA
90022-5103
US

IV. Provider business mailing address

1000 GOODRICH BLVD
COMMERCE CA
90022-5103
US

V. Phone/Fax

Practice location:
  • Phone: 323-832-9795
  • Fax:
Mailing address:
  • Phone: 323-832-9795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: