Provider Demographics
NPI:1053625269
Name:ERICKSON, FLORENCIA R (BA SOCIAL WORK)
Entity type:Individual
Prefix:MRS
First Name:FLORENCIA
Middle Name:R
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:BA SOCIAL WORK
Other - Prefix:MRS
Other - First Name:FLORENCIA
Other - Middle Name:R
Other - Last Name:RUIZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BA SOCIAL WORK
Mailing Address - Street 1:1528 E CAROLINE ST
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-1430
Mailing Address - Country:US
Mailing Address - Phone:909-579-0373
Mailing Address - Fax:
Practice Address - Street 1:801 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-3839
Practice Address - Country:US
Practice Address - Phone:714-680-8268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator