Provider Demographics
NPI:1255640447
Name:MCEACHREN, ERIK J
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:J
Last Name:MCEACHREN
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 1:13741 FOOTHILL BLVD
Mailing Address - Street 2:240
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-3133
Mailing Address - Country:US
Mailing Address - Phone:818-833-9789
Mailing Address - Fax:818-833-9790
Practice Address - Street 1:13741 FOOTHILL BLVD
Practice Address - Street 2:240
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-3133
Practice Address - Country:US
Practice Address - Phone:818-833-9789
Practice Address - Fax:818-833-9790
Is Sole Proprietor?:No
Enumeration Date:2010-10-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)