Provider Demographics
NPI:1285311712
Name:EWING, ERICA JUDITH (PA-C)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:JUDITH
Last Name:EWING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 SANTA FE DR STE 204
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5179
Mailing Address - Country:US
Mailing Address - Phone:616-583-2332
Mailing Address - Fax:
Practice Address - Street 1:320 SANTA FE DR STE 204
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5179
Practice Address - Country:US
Practice Address - Phone:616-583-2332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical