Healthcare Provider Details

I. General information

NPI: 1013388198
Provider Name (Legal Business Name): ERINN CARUSETTA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2015
Last Update Date: 10/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 LA BELLORITA ST
SOUTH PASADENA CA
91030-4225
US

IV. Provider business mailing address

819 LA BELLORITA ST
SOUTH PASADENA CA
91030-4225
US

V. Phone/Fax

Practice location:
  • Phone: 818-497-1315
  • Fax:
Mailing address:
  • Phone: 818-497-1315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberRN839704
License Number StateCA

VIII. Authorized Official

Name: MS. ERINN CARUSETTA
Title or Position: CASE MANAGER
Credential: RN
Phone: 818-497-1315