Provider Demographics
NPI:1346951779
Name:CROSS, ERIC LAMONT (RADT I)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:LAMONT
Last Name:CROSS
Suffix:
Gender:M
Credentials:RADT I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4326 HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-6023
Mailing Address - Country:US
Mailing Address - Phone:925-597-0284
Mailing Address - Fax:
Practice Address - Street 1:4326 HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-6023
Practice Address - Country:US
Practice Address - Phone:925-597-0284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)