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General NPI Number Information
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NPI Number | 1265564108
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Entity Type | Individual
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Provider Name | ERICA MARTHA KEUS OWENS
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Gender | Female
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 10/29/2013
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Provider Practice Location Address
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Address Line | 119 ABERDEEN DR STE 6
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City | CARDIFF
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State | CA
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Zip | 92007-1841
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Country | US
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Telephone | 760-803-5912
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 230318
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City | ENCINITAS
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State | CA
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Zip | 92023-0318
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Country | US
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Telephone | 760-803-5912
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 53613
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License Number State | CA
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