Individual
JENNIFER M ERICSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2725 CAPITOL AVE, SACRAMENTO, CA 95816-6004
(916) 262-9404
Mailing address
PO BOX 276950, SACRAMENTO, CA 95827-6950
(916) 262-9404
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
12118129-1206
UT
363AS0400X
Surgical Physician Assistant
Primary
PA64509
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12118129-1206
PHYSICIAN ASSISTANT STATE LICENSE NUMBER
UT
Enumeration date
02/23/2021
Last updated
03/07/2025
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