Individual
ERICKA DEANN DEROUEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
40700 CALIF OAKS RD STE 202, MURRIETA, CA 92562-5789
(951) 894-5072
Mailing address
85 RAMONA EXPY, PERRIS, CA 92571-7014
(951) 349-4195
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
286341
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578665790
—
CA
Enumeration date
06/26/2019
Last updated
02/10/2023
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