Healthcare Provider Details

I. General information

NPI: 1114597960
Provider Name (Legal Business Name): ERICK JOSEPH MARIN MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2021
Last Update Date: 09/29/2022
Certification Date: 09/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8373 VISTA DEL RIO AVE
DOWNEY CA
90240-2822
US

IV. Provider business mailing address

10155 COLIMA RD
WHITTIER CA
90603-2042
US

V. Phone/Fax

Practice location:
  • Phone: 562-399-3544
  • Fax:
Mailing address:
  • Phone: 562-692-0383
  • Fax: 213-241-3305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number110545
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: