Provider Demographics
NPI:1881229391
Name:PERREIRA, ERIN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:PERREIRA
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 1:24454 VALENCIA BLVD APT 9108
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1840
Mailing Address - Country:US
Mailing Address - Phone:818-468-2536
Mailing Address - Fax:
Practice Address - Street 1:5335 CRANER AVE
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-3313
Practice Address - Country:US
Practice Address - Phone:818-927-4045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-04
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35576167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician