Provider Demographics
NPI:1508091539
Name:PICKETT, ERIN HEWITT
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:HEWITT
Last Name:PICKETT
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 1:961 LAUREL ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-3949
Mailing Address - Country:US
Mailing Address - Phone:650-722-4328
Mailing Address - Fax:
Practice Address - Street 1:961 LAUREL ST
Practice Address - Street 2:SUITE 205
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-3949
Practice Address - Country:US
Practice Address - Phone:650-722-4328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57724106H00000X
CA50940106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist