Healthcare Provider Details

I. General information

NPI: 1831015163
Provider Name (Legal Business Name): SHALLIAH ERICKSEN MS SLP-CCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 W 227TH ST
TORRANCE CA
90505-2208
US

IV. Provider business mailing address

4000 W 227TH ST
TORRANCE CA
90505-2208
US

V. Phone/Fax

Practice location:
  • Phone: 310-972-6500
  • Fax:
Mailing address:
  • Phone: 310-972-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP13575
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: