Provider Demographics
NPI:1619862034
Name:MOTSCHENBACHER, ERIN NICOLE
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:NICOLE
Last Name:MOTSCHENBACHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 PORT DR
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-3688
Mailing Address - Country:US
Mailing Address - Phone:562-569-2589
Mailing Address - Fax:
Practice Address - Street 1:14782 EDEN ST # CA
Practice Address - Street 2:
Practice Address - City:MIDWAY CITY
Practice Address - State:CA
Practice Address - Zip Code:92655-1108
Practice Address - Country:US
Practice Address - Phone:714-894-7261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist