Healthcare Provider Details

I. General information

NPI: 1629906409
Provider Name (Legal Business Name): ERIKA AZCUE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31569 CANYON ESTATES DR STE 105
LAKE ELSINORE CA
92532-0470
US

IV. Provider business mailing address

30182 WESTLAKE DR
MENIFEE CA
92584-8015
US

V. Phone/Fax

Practice location:
  • Phone: 951-852-4357
  • Fax:
Mailing address:
  • Phone: 323-596-8412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC19957
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: