Provider Demographics
NPI:1497902795
Name:SEGURA, ERANDY YURITZIA
Entity Type:Individual
Prefix:
First Name:ERANDY
Middle Name:YURITZIA
Last Name:SEGURA
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 1:1818 W CARLTON PL
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-4205
Mailing Address - Country:US
Mailing Address - Phone:714-979-9782
Mailing Address - Fax:
Practice Address - Street 1:1745 W ORANGEWOOD AVE STE 103
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2041
Practice Address - Country:US
Practice Address - Phone:714-221-6400
Practice Address - Fax:714-221-6401
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker