Provider Demographics
NPI:1669916581
Name:FRIAS, ERICA ANN
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:ANN
Last Name:FRIAS
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 1:284 GRAND TETON DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-4164
Mailing Address - Country:US
Mailing Address - Phone:925-549-5384
Mailing Address - Fax:
Practice Address - Street 1:3909 S MARYLAND PKWY STE 311
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-7520
Practice Address - Country:US
Practice Address - Phone:925-549-5384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician