Healthcare Provider Details

I. General information

NPI: 1629279963
Provider Name (Legal Business Name): ERIKA LOZADA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 08/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RR 9 BOX 887
SAN JUAN PR
00926-9935
US

IV. Provider business mailing address

CALLE LUIS VIGO H-14
CAROLINA PR
00987-6808
US

V. Phone/Fax

Practice location:
  • Phone: 787-755-6811
  • Fax: 787-760-1598
Mailing address:
  • Phone: 787-356-8033
  • Fax: 787-760-1598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number6881
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: