Provider Demographics
NPI:1639866866
Name:ALBRIGHT, ERICA GRACE (LVN/LPN)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:GRACE
Last Name:ALBRIGHT
Suffix:
Gender:F
Credentials:LVN/LPN
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:GRACE
Other - Last Name:COPPEDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN/LPN
Mailing Address - Street 1:7710 HAZARD CENTER DR # 131
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-4550
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:621 I ST
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-5110
Practice Address - Country:US
Practice Address - Phone:619-651-2194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016029412164W00000X
CA724181164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse