Healthcare Provider Details

I. General information

NPI: 1457573735
Provider Name (Legal Business Name): ERIN PERKINS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1928 SAINT MARYS RD
MORAGA CA
94556-2715
US

IV. Provider business mailing address

PO BOX 3006
MORAGA CA
94575-3006
US

V. Phone/Fax

Practice location:
  • Phone: 925-631-4254
  • Fax: 925-376-2238
Mailing address:
  • Phone: 925-631-4254
  • Fax: 925-376-2238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number768263
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number19758
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: