Healthcare Provider Details

I. General information

NPI: 1841811304
Provider Name (Legal Business Name): ERIN OCEGUEDA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2020
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 2589
SAN GABRIEL CA
91778-2589
US

IV. Provider business mailing address

PO BOX 2589
SAN GABRIEL CA
91778-2589
US

V. Phone/Fax

Practice location:
  • Phone: 203-319-9528
  • Fax:
Mailing address:
  • Phone: 213-309-9628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP95036498
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP60860346
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: