Individual
ERICA RENEE DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1865 9TH ST, SANTA MONICA, CA 90404-4501
(310) 314-6200
(310) 450-2024
Mailing address
19635 VICTORY BLVD, RESEDA, CA 91335-6621
(213) 435-2139
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
693140
CA
Other
Enumeration date
09/10/2019
Last updated
09/10/2019
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