Provider Demographics
NPI:1164149845
Name:TIMMINS, ERICKA (MA, PSYCH ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:ERICKA
Middle Name:
Last Name:TIMMINS
Suffix:
Gender:F
Credentials:MA, PSYCH ASSOCIATE
Other - Prefix:
Other - First Name:ERICKA
Other - Middle Name:
Other - Last Name:WRAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, PSYCH ASSOCIATE
Mailing Address - Street 1:8858 LEMON AVE
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-5426
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:780 BAY BLVD STE 203
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-5261
Practice Address - Country:US
Practice Address - Phone:619-842-2442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist