Provider Demographics
NPI:1982491155
Name:PAGE, ERICA TIFFANY (MSW, PPSC-SSW)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:TIFFANY
Last Name:PAGE
Suffix:
Gender:
Credentials:MSW, PPSC-SSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 LAKE EARL DR
Mailing Address - Street 2:
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531-7909
Mailing Address - Country:US
Mailing Address - Phone:707-464-0360
Mailing Address - Fax:
Practice Address - Street 1:6900 LAKE EARL DR
Practice Address - Street 2:
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95531-7909
Practice Address - Country:US
Practice Address - Phone:707-464-0360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool