Healthcare Provider Details

I. General information

NPI: 1386101053
Provider Name (Legal Business Name): ERIK LUGO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2019
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7141 WOODLEY AVE
VAN NUYS CA
91406-3932
US

IV. Provider business mailing address

7141 WOODLEY AVE
VAN NUYS CA
91406-3932
US

V. Phone/Fax

Practice location:
  • Phone: 818-285-8252
  • Fax: 818-273-1831
Mailing address:
  • Phone: 818-285-8252
  • Fax: 818-273-1831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-18-47106
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-82975
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: