Provider Demographics
NPI:1538674072
Name:BENNETT, ERICA (CCE, SBD)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:
Last Name:BENNETT
Suffix:
Gender:F
Credentials:CCE, SBD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17300 GRAND PRIX WAY
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-3781
Mailing Address - Country:US
Mailing Address - Phone:408-406-6701
Mailing Address - Fax:
Practice Address - Street 1:17300 GRAND PRIX WAY
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-3781
Practice Address - Country:US
Practice Address - Phone:408-406-6701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-06
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula