Provider Demographics
NPI:1477946747
Name:CRUZ, ERIKA (NP)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24012 CALLE DE LA PLATA
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3621
Mailing Address - Country:US
Mailing Address - Phone:949-588-7246
Mailing Address - Fax:562-427-7246
Practice Address - Street 1:24012 CALLE DE LA PLATA
Practice Address - Street 2:SUITE 120
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3621
Practice Address - Country:US
Practice Address - Phone:949-588-7246
Practice Address - Fax:562-427-7246
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95002152363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner