Provider Demographics
NPI:1407392848
Name:PACHECO, ERICA
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:PACHECO
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 1:1041 PIERCE DR
Mailing Address - Street 2:APT B
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-1540
Mailing Address - Country:US
Mailing Address - Phone:559-797-7646
Mailing Address - Fax:
Practice Address - Street 1:1041 PIERCE DR
Practice Address - Street 2:APT B
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-1540
Practice Address - Country:US
Practice Address - Phone:559-797-7646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor