Provider Demographics
NPI:1124988795
Name:HOSOMI, ERIYA
Entity type:Individual
Prefix:
First Name:ERIYA
Middle Name:
Last Name:HOSOMI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7684 KUVERA BEND ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-1474
Mailing Address - Country:US
Mailing Address - Phone:714-457-6200
Mailing Address - Fax:714-463-8186
Practice Address - Street 1:185 S STATE COLLEGE BLVD STE 69
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5829
Practice Address - Country:US
Practice Address - Phone:840-278-3569
Practice Address - Fax:840-278-3569
Is Sole Proprietor?:No
Enumeration Date:2025-11-14
Last Update Date:2025-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician