Provider Demographics
NPI:1841769320
Name:ERICSON, CATRINA
Entity Type:Individual
Prefix:
First Name:CATRINA
Middle Name:
Last Name:ERICSON
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 1:21515 HAWTHORNE BLVD STE G100
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6501
Mailing Address - Country:US
Mailing Address - Phone:424-571-2618
Mailing Address - Fax:424-571-2339
Practice Address - Street 1:21515 HAWTHORNE BLVD
Practice Address - Street 2:STE G100
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6503
Practice Address - Country:US
Practice Address - Phone:424-571-2618
Practice Address - Fax:424-571-2339
Is Sole Proprietor?:No
Enumeration Date:2018-11-14
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst