Provider Demographics
NPI:1619235777
Name:WASHINGTON, ERICA (MSW, ACSW)
Entity Type:Individual
Prefix:MS
First Name:ERICA
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:MSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4508 ATLANTIC AVE # 250
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-1520
Mailing Address - Country:US
Mailing Address - Phone:256-394-6867
Mailing Address - Fax:
Practice Address - Street 1:23161 MILL CREEK DR STE 230
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7935
Practice Address - Country:US
Practice Address - Phone:949-264-5350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-26
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95523104100000X
171M00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator