Provider Demographics
NPI:1023401791
Name:TOLENTINO, ERICA M (NP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:M
Last Name:TOLENTINO
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:4204 GARDENDALE STREET
Mailing Address - Street 2:SUITE 312
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3141
Mailing Address - Country:US
Mailing Address - Phone:210-293-6006
Mailing Address - Fax:210-614-1722
Practice Address - Street 1:4204 GARDENDALE STREET
Practice Address - Street 2:SUITE 312
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3141
Practice Address - Country:US
Practice Address - Phone:210-293-6006
Practice Address - Fax:210-614-1722
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-05
Last Update Date:2015-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXAP127604363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily