Provider Demographics
NPI:1073761037
Name:MCANOY, ERIN JOY TERHORST (NP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:JOY TERHORST
Last Name:MCANOY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:JOY
Other - Last Name:TERHORST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0309
Mailing Address - Country:US
Mailing Address - Phone:818-952-2222
Mailing Address - Fax:
Practice Address - Street 1:1812 VERDUGO BLVD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-1407
Practice Address - Country:US
Practice Address - Phone:818-952-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA720122163W00000X
NY574324-1163W00000X
CA18380363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1902846306OtherGROUP NPI
CAGROO16910OtherGROUP MEDICAID PIN
CACE1617OtherGROUP RAILROAD MEDICARE
CAW11675OtherGROUP MEDICARE PIN
CA1356390009OtherGROUP NPI
CAGR0100430OtherGROUP MEDICAL
CAW18762OtherGROUP MEDICARE