Provider Demographics
NPI:1376794198
Name:TANIGUCHI, ERIN ELISA-LOREDO (LAC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ELISA-LOREDO
Last Name:TANIGUCHI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:ELISA
Other - Last Name:LOREDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1620 N TREKELL RD UNIT 163
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-0023
Mailing Address - Country:US
Mailing Address - Phone:808-436-2030
Mailing Address - Fax:
Practice Address - Street 1:1620 N TREKELL RD UNIT 163
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-0023
Practice Address - Country:US
Practice Address - Phone:808-436-2030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
AZLAC-23368101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor