Provider Demographics
NPI:1649085101
Name:SIEPKER, ERICA A (BS)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:A
Last Name:SIEPKER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 W ORANGEWOOD AVE STE 323
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-2094
Mailing Address - Country:US
Mailing Address - Phone:714-929-1004
Mailing Address - Fax:
Practice Address - Street 1:1835 W ORANGEWOOD AVE STE 323
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2094
Practice Address - Country:US
Practice Address - Phone:714-929-1004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician