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Individual

ERICA LYNN STEPHENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1533 EUCLID ST, SANTA MONICA, CA 90404-3306
(310) 451-9747
Mailing address
1267 BARRY AVE, 7, LOS ANGELES, CA 90025-1727

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
95-1647832
TAX ID
CA
Enumeration date
07/12/2010
Last updated
07/12/2010
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