Provider Demographics
NPI:1053503144
Name:THURMAN, ERIN E (PA)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:E
Last Name:THURMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 PROMONTORY TER
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1569
Mailing Address - Country:US
Mailing Address - Phone:209-631-1492
Mailing Address - Fax:
Practice Address - Street 1:5150 HILL RD E STE E
Practice Address - Street 2:
Practice Address - City:LAKEPORT
Practice Address - State:CA
Practice Address - Zip Code:95453-5100
Practice Address - Country:US
Practice Address - Phone:707-263-4360
Practice Address - Fax:707-263-4036
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1076844363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical