Healthcare Provider Details

I. General information

NPI: 1740092352
Provider Name (Legal Business Name): ERICA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2025
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6226 E SPRING ST STE 260
LONG BEACH CA
90815-1454
US

IV. Provider business mailing address

118 W AVENIDA DE LOS LOBOS MARINOS
SAN CLEMENTE CA
92672-4358
US

V. Phone/Fax

Practice location:
  • Phone: 562-735-3400
  • Fax:
Mailing address:
  • Phone: 949-295-3230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number66343
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: