Provider Demographics
NPI:1598283269
Name:VAZ, ERIKA CHRISTABELLE
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:CHRISTABELLE
Last Name:VAZ
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 1:2044 MARENGO ST # B
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-1353
Mailing Address - Country:US
Mailing Address - Phone:323-647-9481
Mailing Address - Fax:
Practice Address - Street 1:900 CALLE DE LOS AMIGOS
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4435
Practice Address - Country:US
Practice Address - Phone:800-750-5089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-01
Last Update Date:2017-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist