Healthcare Provider Details

I. General information

NPI: 1780145607
Provider Name (Legal Business Name): YVONNE ERUSIAFE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2019
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 OAK RD STE 270
WALNUT CREEK CA
94597-2078
US

IV. Provider business mailing address

3100 OAK RD STE 270
WALNUT CREEK CA
94597-2078
US

V. Phone/Fax

Practice location:
  • Phone: 619-272-0400
  • Fax:
Mailing address:
  • Phone: 619-272-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberU8525
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number89105
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA185732
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: