Healthcare Provider Details

I. General information

NPI: 1720628845
Provider Name (Legal Business Name): ERICA TARENS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2020
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date: 03/09/2026
Reactivation Date: 03/16/2026

III. Provider practice location address

160 W ESSEX ST
CRESCENT CITY CA
95531-3311
US

IV. Provider business mailing address

160 W ESSEX ST
CRESCENT CITY CA
95531-3311
US

V. Phone/Fax

Practice location:
  • Phone: 650-996-9102
  • Fax:
Mailing address:
  • Phone: 650-996-9102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: