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General NPI Number Information
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NPI Number | 1417141441
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Entity Type | Individual
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Provider Name | ERICA DAWN VERKAMP C.O.T.A./C
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Gender | Female
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Dates
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Enumeration Date | 09/03/2007
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Last Update Date | 09/03/2007
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Provider Practice Location Address
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Address Line | 1600 S POMONA AVE UNIT C7
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City | FULLERTON
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State | CA
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Zip | 92832-3440
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Country | US
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Telephone | 714-356-5204
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 S POMONA AVE UNIT C7
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City | FULLERTON
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State | CA
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Zip | 92832-3440
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Country | US
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Telephone | 714-356-5204
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 1478
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License Number State | CA
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