Provider Demographics
NPI:1104645852
Name:PURCELL, ERIK JAMES (PMHNP)
Entity type:Individual
Prefix:MR
First Name:ERIK
Middle Name:JAMES
Last Name:PURCELL
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7021 BARWICK CT
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-3938
Mailing Address - Country:US
Mailing Address - Phone:909-260-8756
Mailing Address - Fax:
Practice Address - Street 1:7021 BARWICK CT
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:92880-3938
Practice Address - Country:US
Practice Address - Phone:909-260-8756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA803422363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health