Provider Demographics
NPI:1376232769
Name:ARIAS MENDOZA, ERIK DANIEL
Entity Type:Individual
Prefix:MR
First Name:ERIK
Middle Name:DANIEL
Last Name:ARIAS MENDOZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 40TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-2633
Mailing Address - Country:US
Mailing Address - Phone:510-613-0330
Mailing Address - Fax:
Practice Address - Street 1:390 40TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-2633
Practice Address - Country:US
Practice Address - Phone:510-613-0330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1176561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical