Provider Demographics
NPI:1417195959
Name:MANN, ERICA SUZANNE (PMHNP)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:SUZANNE
Last Name:MANN
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4712 E 2ND ST # 137
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-5309
Mailing Address - Country:US
Mailing Address - Phone:562-449-0206
Mailing Address - Fax:562-449-0255
Practice Address - Street 1:217 REDONDO AVE APT C
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-5930
Practice Address - Country:US
Practice Address - Phone:423-268-3878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95017497363LP0808X
NC5011499363L00000X
TN158773163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP95017497OtherCA BOARD OF NURSING