Provider Demographics
NPI:1922452622
Name:GARCIA TABULLO, ERIKA FABIOLA (ASW)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:FABIOLA
Last Name:GARCIA TABULLO
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7333 LOCKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94621-2701
Mailing Address - Country:US
Mailing Address - Phone:510-300-3500
Mailing Address - Fax:510-467-5173
Practice Address - Street 1:20094 MISSION BLVD
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-1237
Practice Address - Country:US
Practice Address - Phone:510-727-9765
Practice Address - Fax:510-727-9761
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 174H00000X, 390200000X
CAASW111497104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No174H00000XOther Service ProvidersHealth Educator
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program