Healthcare Provider Details

I. General information

NPI: 1386536977
Provider Name (Legal Business Name): ERICA MARIE MOYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 07/17/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 S HIGHWAY 101 STE E
SOLANA BEACH CA
92075-2629
US

IV. Provider business mailing address

1921 E POINTE AVE
CARLSBAD CA
92008-3775
US

V. Phone/Fax

Practice location:
  • Phone: 858-314-8437
  • Fax:
Mailing address:
  • Phone: 925-963-6594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number154200
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: