Provider Demographics
NPI:1275250110
Name:ANDRADE, ERICA CHRISTINA
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:CHRISTINA
Last Name:ANDRADE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 SEBASTIAN WAY
Mailing Address - Street 2:
Mailing Address - City:NIPOMO
Mailing Address - State:CA
Mailing Address - Zip Code:93444-5500
Mailing Address - Country:US
Mailing Address - Phone:805-904-7957
Mailing Address - Fax:
Practice Address - Street 1:1086 E GRAND AVE
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-2505
Practice Address - Country:US
Practice Address - Phone:805-473-4272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-21
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide