Healthcare Provider Details

I. General information

NPI: 1194697227
Provider Name (Legal Business Name): ERICA GLIGA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5482 WILSHIRE BLVD # 255
LOS ANGELES CA
90036-4218
US

IV. Provider business mailing address

5482 WILSHIRE BLVD # 255
LOS ANGELES CA
90036-4218
US

V. Phone/Fax

Practice location:
  • Phone: 213-986-6595
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number24385
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: