Provider Demographics
NPI:1124894993
Name:VALDERRAMOS, ERIKA JINETH (MHC)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:JINETH
Last Name:VALDERRAMOS
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 ELM ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-3907
Mailing Address - Country:US
Mailing Address - Phone:315-316-8508
Mailing Address - Fax:
Practice Address - Street 1:628 MARY ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-2419
Practice Address - Country:US
Practice Address - Phone:315-272-2723
Practice Address - Fax:315-272-2710
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)