Healthcare Provider Details

I. General information

NPI: 1356088074
Provider Name (Legal Business Name): ERIN LUTTRINGER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2022
Last Update Date: 05/14/2022
Certification Date: 05/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 CALIFORNIA ST
REDLANDS CA
92374-2910
US

IV. Provider business mailing address

6282 SHAKER DR
RIVERSIDE CA
92506-4741
US

V. Phone/Fax

Practice location:
  • Phone: 909-809-3030
  • Fax:
Mailing address:
  • Phone: 951-217-9518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number825580
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: