Individual
ERICA TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1120 W LA VETA AVE STE 300, ORANGE, CA 92868-4246
(714) 332-5503
Mailing address
3312 ROSEGOLD AVE, ROSAMOND, CA 93560-5943
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/28/2023
Last updated
05/16/2024
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