=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932740412
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERICA DANIELLE FLITCRAFT CADC-II
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/04/2019
-----------------------------------------------------
Last Update Date | 06/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3333 E AMERICAN AVE
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93725-9247
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-600-7395
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2212 N WINERY AVE STE 122
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93703-2896
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-600-7395
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | AII053030318
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------