Provider Demographics
NPI:1629771951
Name:EDNEY, ERIKA R
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:R
Last Name:EDNEY
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 1:78140 CALLE TAMPICO
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-2900
Mailing Address - Country:US
Mailing Address - Phone:951-509-8200
Mailing Address - Fax:
Practice Address - Street 1:78140 CALLE TAMPICO
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-2900
Practice Address - Country:US
Practice Address - Phone:951-509-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist