Healthcare Provider Details

I. General information

NPI: 1114701588
Provider Name (Legal Business Name): ERICA DOO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2023
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6386 ALVARADO CT STE 310
SAN DIEGO CA
92120-4908
US

IV. Provider business mailing address

6386 ALVARADO CT STE 310
SAN DIEGO CA
92120-4908
US

V. Phone/Fax

Practice location:
  • Phone: 619-668-6200
  • Fax: 619-668-6202
Mailing address:
  • Phone: 619-668-6200
  • Fax: 619-668-6202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: