Provider Demographics
NPI:1841006640
Name:FLORES, ERICA MICHELLE (DPT)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:MICHELLE
Last Name:FLORES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4183 ALABAMA ST APT 9
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-7004
Mailing Address - Country:US
Mailing Address - Phone:219-512-8029
Mailing Address - Fax:
Practice Address - Street 1:4183 ALABAMA ST APT 9
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-7004
Practice Address - Country:US
Practice Address - Phone:219-512-8029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA307122225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist