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General NPI Number Information
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NPI Number | 1275180747
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Entity Type | Individual
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Provider Name | ERICA MICHELLE SEQUEIRA
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Gender | Female
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 08/20/2019
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Provider Practice Location Address
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Address Line | 1940 LEVANTE ST
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City | CARLSBAD
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State | CA
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Zip | 92009-5174
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Country | US
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Telephone | 800-852-4384
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Fax |
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Provider Business Mailing Address
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Address Line | 1501 E GRAND AVE APT 1111
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City | ESCONDIDO
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State | CA
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Zip | 92027-3166
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Country | US
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Telephone | 415-596-1368
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 20118
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License Number State | CA
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