MEDICARE: ERIKA HO RADT

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	R1232571016	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447737176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIKA HO RADT

Provider Business Mailing Address
First Line	:	3969 NOBEL DR UNIT 280
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92122-5738
Country	:	US
Telephone Number	:	858-218-4549
Fax Number	:

Provider Business Practice Location Address
First Line	:	3969 NOBEL DR UNIT 280
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92122-5738
Country	:	US
Telephone Number	:	858-218-4549
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2018
Last Update Date	:	07/25/2018

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Directions to “ ERIKA HO RADT” Practice Location

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