Provider Demographics
NPI:1669930822
Name:COVARRUBIAS, ERICA KAUR
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:KAUR
Last Name:COVARRUBIAS
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 1:7096 ANJOU CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95120-4106
Mailing Address - Country:US
Mailing Address - Phone:408-455-9232
Mailing Address - Fax:
Practice Address - Street 1:31 N 2ND ST # 265
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95113-1231
Practice Address - Country:US
Practice Address - Phone:408-455-9232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health