Healthcare Provider Details

I. General information

NPI: 1326490996
Provider Name (Legal Business Name): ERIKA VENEGAS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2016
Last Update Date: 11/21/2022
Certification Date: 11/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PACIFIC CLINICS 2550 E. FOOTHILL BLVD.
PASADENA CA
91107
US

IV. Provider business mailing address

5410 LORENZA CT
SAN GABRIEL CA
91776-2140
US

V. Phone/Fax

Practice location:
  • Phone: 626-744-5230
  • Fax:
Mailing address:
  • Phone: 626-607-9773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT135903
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMF103137
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: