Provider Demographics
NPI:1336455922
Name:ERWIN, JOHN EMORY JR (MBA)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:EMORY
Last Name:ERWIN
Suffix:JR
Gender:M
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 RACE ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-4823
Mailing Address - Country:US
Mailing Address - Phone:408-510-3480
Mailing Address - Fax:408-510-3484
Practice Address - Street 1:237 RACE ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-4823
Practice Address - Country:US
Practice Address - Phone:408-510-3480
Practice Address - Fax:408-510-3484
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health