Healthcare Provider Details

I. General information

NPI: 1871353367
Provider Name (Legal Business Name): ERIKA A LUTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 03/21/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1334 N WHITMAN LN STE 140
LIBERTY LAKE WA
99019-6034
US

IV. Provider business mailing address

987 SHELLWOOD WAY
SACRAMENTO CA
95831-3855
US

V. Phone/Fax

Practice location:
  • Phone: 509-443-5015
  • Fax:
Mailing address:
  • Phone: 916-704-4981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: