Healthcare Provider Details

I. General information

NPI: 1770411316
Provider Name (Legal Business Name): ERIKA NOEMI GONZALEZ RODRIGUEZ MASSAGE THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25912 BARTRAM CT
MORENO VALLEY CA
92553-4720
US

IV. Provider business mailing address

25912 BARTRAM CT
MORENO VALLEY CA
92553-4720
US

V. Phone/Fax

Practice location:
  • Phone: 909-588-4707
  • Fax:
Mailing address:
  • Phone: 909-588-4707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number99060
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: