Healthcare Provider Details

I. General information

NPI: 1467299065
Provider Name (Legal Business Name): ERICA HURTADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2024
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2958 E FLORENCE AVE
HUNTINGTON PARK CA
90255-5826
US

IV. Provider business mailing address

900 CORPORATE CENTER DR STE 350
MONTEREY PARK CA
91754-7620
US

V. Phone/Fax

Practice location:
  • Phone: 323-526-4016
  • Fax:
Mailing address:
  • Phone: 323-526-4016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: