Provider Demographics
NPI:1891042917
Name:LYONS, ERIN THERESE (NP)
Entity Type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:THERESE
Last Name:LYONS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:25311 ESHELMAN AVE .
Mailing Address - Street 2:UNIT 4
Mailing Address - City:LOMITA
Mailing Address - State:CA
Mailing Address - Zip Code:90717-9998
Mailing Address - Country:US
Mailing Address - Phone:714-357-4938
Mailing Address - Fax:
Practice Address - Street 1:1000 WEST CARSON ST.
Practice Address - Street 2:BOX 17
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90509
Practice Address - Country:US
Practice Address - Phone:310-222-2342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22119363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics