Provider Demographics
NPI:1043183882
Name:STITH, ERICA KATHERINE
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:KATHERINE
Last Name:STITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:STITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4820 BUSINESS CENTER DR STE 210
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-1696
Mailing Address - Country:US
Mailing Address - Phone:707-319-5756
Mailing Address - Fax:
Practice Address - Street 1:4820 BUSINESS CENTER DR STE 210
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-1696
Practice Address - Country:US
Practice Address - Phone:707-224-8266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6BC25D3939171400000X
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171400000XOther Service ProvidersHealth & Wellness Coach