Provider Demographics
NPI:1467955120
Name:TAPIA, ERIC M (LVN)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:M
Last Name:TAPIA
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 N BUSH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-2816
Mailing Address - Country:US
Mailing Address - Phone:714-361-7950
Mailing Address - Fax:714-361-7966
Practice Address - Street 1:1910 N BUSH ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-2816
Practice Address - Country:US
Practice Address - Phone:714-361-7950
Practice Address - Fax:714-361-7966
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA694049164X00000X
CA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No164X00000XNursing Service ProvidersLicensed Vocational Nurse