Provider Demographics
NPI:1174865729
Name:JENKINS, ERICA MARIE (NP, RN)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:MARIE
Last Name:JENKINS
Suffix:
Gender:F
Credentials:NP, RN
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Other - First Name:
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Mailing Address - Street 1:100 UCLA MEDICAL PLAZA SUITE 760
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-0001
Mailing Address - Country:US
Mailing Address - Phone:310-264-7246
Mailing Address - Fax:310-882-7005
Practice Address - Street 1:100 UCLA MEDICAL PLZ STE 760
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-6990
Practice Address - Country:US
Practice Address - Phone:310-264-7246
Practice Address - Fax:310-882-7005
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA21160363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology