Provider Demographics
NPI:1942462866
Name:LOBERG, ERICA
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:LOBERG
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 1:695 S. VERMONT AVENUE
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-0000
Mailing Address - Country:US
Mailing Address - Phone:213-216-8834
Mailing Address - Fax:213-216-8834
Practice Address - Street 1:1925 DALY ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90031-3309
Practice Address - Country:US
Practice Address - Phone:323-226-4448
Practice Address - Fax:323-223-8380
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator