Provider Demographics
NPI:1154775286
Name:MIRAMONTES, ERIKA (MA, BCBA)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:MIRAMONTES
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 N VULCAN AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2190
Mailing Address - Country:US
Mailing Address - Phone:760-634-1125
Mailing Address - Fax:760-634-1530
Practice Address - Street 1:38975 SKY CANYON DR
Practice Address - Street 2:SUITE 103
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2675
Practice Address - Country:US
Practice Address - Phone:760-634-1125
Practice Address - Fax:760-634-1530
Is Sole Proprietor?:No
Enumeration Date:2016-04-14
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABCBA1-16-21716103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst