Provider Demographics
NPI:1063387785
Name:TAYAG, ERIN CAMILLE
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:CAMILLE
Last Name:TAYAG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 PARK SHADOW CT
Mailing Address - Street 2:
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-3280
Mailing Address - Country:US
Mailing Address - Phone:626-678-3853
Mailing Address - Fax:
Practice Address - Street 1:150 W FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-1103
Practice Address - Country:US
Practice Address - Phone:626-988-6583
Practice Address - Fax:626-884-1196
Is Sole Proprietor?:No
Enumeration Date:2025-10-10
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1042061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical