Provider Demographics
NPI:1134421142
Name:PICCOLA, ERIN SILVER (LAC, DIPLOM)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:SILVER
Last Name:PICCOLA
Suffix:
Gender:F
Credentials:LAC, DIPLOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 FIRWOOD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4633
Mailing Address - Country:US
Mailing Address - Phone:775-901-0308
Mailing Address - Fax:
Practice Address - Street 1:26700 TOWNE CENTRE DR
Practice Address - Street 2:STE 100
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2844
Practice Address - Country:US
Practice Address - Phone:949-460-9111
Practice Address - Fax:949-460-9055
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13890171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist