Provider Demographics
NPI:1609203371
Name:LANDERS, ERICA JADE (DPT)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:JADE
Last Name:LANDERS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:5767 W CENTURY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:310-496-0868
Practice Address - Street 1:2211 W MAGNOLIA BLVD STE 160
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-1757
Practice Address - Country:US
Practice Address - Phone:818-876-4195
Practice Address - Fax:818-729-0410
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA369012251X0800X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation