Provider Demographics
NPI:1619111754
Name:FRONTINO, ERICA ANNE
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:ANNE
Last Name:FRONTINO
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 1:17700 SCOTTSDALE RD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-9423
Mailing Address - Country:US
Mailing Address - Phone:951-295-8281
Mailing Address - Fax:951-742-8187
Practice Address - Street 1:17700 SCOTTSDALE RD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-9423
Practice Address - Country:US
Practice Address - Phone:951-295-8281
Practice Address - Fax:951-742-8187
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health