Provider Demographics
NPI:1285922351
Name:VELASQUEZ, ERICA
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:
Last Name:VELASQUEZ
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 1:1060 HOWARD ST
Mailing Address - Street 2:STE. 300
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2820
Mailing Address - Country:US
Mailing Address - Phone:415-233-5313
Mailing Address - Fax:
Practice Address - Street 1:1060 HOWARD ST
Practice Address - Street 2:STE. 300
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2820
Practice Address - Country:US
Practice Address - Phone:415-233-5313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator