Healthcare Provider Details
I. General information
NPI: 1285478495
Provider Name (Legal Business Name): ERICK GEOVANNY ARGUETA CATALAN BHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/21/2024
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date: 07/10/2025
Reactivation Date: 06/19/2026
III. Provider practice location address
18646 OXNARD ST
TARZANA CA
91356-1486
US
IV. Provider business mailing address
2318 PEYTON AVE
BURBANK CA
91504-2734
US
V. Phone/Fax
- Phone: 818-287-9432
- Fax:
- Phone: 818-287-9432
- Fax: 818-287-9432
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175T00000X |
| Taxonomy | Peer Specialist |
| License Number | MPSS-NCMTIQ |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: