Provider Demographics
NPI:1245656339
Name:DICKSON, ERICA (DO)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:DICKSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11160 WARNER AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4055
Mailing Address - Country:US
Mailing Address - Phone:714-210-5665
Mailing Address - Fax:714-210-0231
Practice Address - Street 1:11160 WARNER AVE STE 301
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4055
Practice Address - Country:US
Practice Address - Phone:714-210-5665
Practice Address - Fax:714-210-0231
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-13
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A14162207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology