Provider Demographics
NPI:1003425539
Name:SWICK, ERICA LOUISE (HHP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:LOUISE
Last Name:SWICK
Suffix:
Gender:F
Credentials:HHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 HILLTOP DR
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-3141
Mailing Address - Country:US
Mailing Address - Phone:619-665-8384
Mailing Address - Fax:
Practice Address - Street 1:8312 LAKE MURRAY BLVD STE O
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92119-3435
Practice Address - Country:US
Practice Address - Phone:619-333-8384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21002225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist