Healthcare Provider Details

I. General information

NPI: 1801751052
Provider Name (Legal Business Name): ERIN TUNIECIA GANTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 WILLOW RD
MENLO PARK CA
94025-2539
US

IV. Provider business mailing address

1406 LANSING AVE
SAN JOSE CA
95118-2432
US

V. Phone/Fax

Practice location:
  • Phone: 650-376-8641
  • Fax:
Mailing address:
  • Phone: 925-252-3585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: