Individual
ERICA I SELF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
1103 N B ST STE E, SACRAMENTO, CA 95811-0326
(916) 378-8266
Mailing address
1103 N B ST STE E, SACRAMENTO, CA 95811-0326
(916) 378-8266
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
42090
CA
Other
Enumeration date
08/19/2021
Last updated
08/19/2021
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