Provider Demographics
NPI:1912343930
Name:ADDAMS, ERIN (MS)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:ADDAMS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 2033
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93613
Mailing Address - Country:US
Mailing Address - Phone:559-593-2854
Mailing Address - Fax:559-314-6113
Practice Address - Street 1:PO BOX 144
Practice Address - Street 2:
Practice Address - City:OCEANO
Practice Address - State:CA
Practice Address - Zip Code:93475-0144
Practice Address - Country:US
Practice Address - Phone:559-593-2854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA045901017101Y00000X
TX13202101YA0400X
CA13808719101YA0400X
TX202508101YM0800X, 106H00000X
CA102920106H00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist