Individual
DR. ERICKSON CRUZ BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.N.P
Contact information
Practice address
6926 BROCKTON AVE STE 8, RIVERSIDE, CA 92506-3804
(877) 414-7739
Mailing address
18411 CRENSHAW BLVD STE 110, TORRANCE, CA 90504-5078
(310) 817-5665
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
715867
CA
163WG0600X
Gerontology Registered Nurse
822775
NV
363L00000X
Nurse Practitioner
95002040
CA
363LA2200X
Adult Health Nurse Practitioner
822775
NV
363LA2200X
Adult Health Nurse Practitioner
Primary
95002040
CA
363LG0600X
Gerontology Nurse Practitioner
822775
NV
363LG0600X
Gerontology Nurse Practitioner
95002040
CA
Other
Enumeration date
01/31/2015
Last updated
05/17/2023
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