Provider Demographics
NPI:1790434470
Name:BOYKINS, ERICA JOCELYN
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:JOCELYN
Last Name:BOYKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ERICA
Other - Middle Name:JOCELYN
Other - Last Name:SALCEDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:359 NE BRYANT ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-2903
Mailing Address - Country:US
Mailing Address - Phone:719-213-3349
Mailing Address - Fax:
Practice Address - Street 1:359 NE BRYANT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211-2903
Practice Address - Country:US
Practice Address - Phone:719-213-3349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104535104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker