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NPI Code Detail

MEDICARE: ERICA ANTOINETTE HIGGINS

MEDICARE: ERICA ANTOINETTE HIGGINS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianCA

General Provider Information

NPI Number : 1205334117
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA ANTOINETTE HIGGINS
Provider Business Mailing Address
First Line : 21600 OXNARD ST STE 1800
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-7807
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3491 ELM AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90807-4430
Country : US
Telephone Number : 562-999-7789
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2018
Last Update Date : 01/25/2018

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Directions to “ ERICA ANTOINETTE HIGGINS ” Practice Location

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