Healthcare Provider Details

I. General information

NPI: 1538427729
Provider Name (Legal Business Name): ERIKA JULIET HILDEBRANDT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2012
Last Update Date: 05/26/2022
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33100 COUNTY ROAD 31
DAVIS CA
95616-9523
US

IV. Provider business mailing address

33100 COUNTY ROAD 31
DAVIS CA
95616-9523
US

V. Phone/Fax

Practice location:
  • Phone: 305-702-6007
  • Fax: 530-702-6097
Mailing address:
  • Phone: 305-702-6007
  • Fax: 210-539-5467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC008854
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: