Provider Demographics
NPI:1972044626
Name:ENCINAS, ERIC A (ATC)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:A
Last Name:ENCINAS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2043 CHIVERS ST
Mailing Address - Street 2:
Mailing Address - City:SAN FERNANDO
Mailing Address - State:CA
Mailing Address - Zip Code:91340-1007
Mailing Address - Country:US
Mailing Address - Phone:818-270-0727
Mailing Address - Fax:
Practice Address - Street 1:2043 CHIVERS ST
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-1007
Practice Address - Country:US
Practice Address - Phone:818-270-0727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer