Provider Demographics
NPI:1093539462
Name:ERAN, RICKY SARABOSQUEZ (APRN, FNP-C)
Entity type:Individual
Prefix:MR
First Name:RICKY
Middle Name:SARABOSQUEZ
Last Name:ERAN
Suffix:
Gender:M
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 MELVILLE SQ APT 103
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804-4556
Mailing Address - Country:US
Mailing Address - Phone:352-562-5512
Mailing Address - Fax:
Practice Address - Street 1:1205 MELVILLE SQ APT 103
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94804-4556
Practice Address - Country:US
Practice Address - Phone:352-562-5512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95025889363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily