Healthcare Provider Details

I. General information

NPI: 1225919921
Provider Name (Legal Business Name): ERICA MARIE ROBLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000A EMELINE AVE
SANTA CRUZ CA
95060-1900
US

IV. Provider business mailing address

200 7TH AVE STE 150
SANTA CRUZ CA
95062-4669
US

V. Phone/Fax

Practice location:
  • Phone: 831-462-1060
  • Fax:
Mailing address:
  • Phone: 831-462-1060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-RXLVWP
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: