Basic Information
| Provider Information | |||||||||
| NPI: | 1518519503 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIERRA | ||||||||
| FirstName: | ERICA | ||||||||
| MiddleName: | ELISSA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2085 RUSTIN AVE OFC 2157 | ||||||||
| Address2: | |||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925072498 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9519557198 | ||||||||
| FaxNumber: | 9519557205 | ||||||||
| Practice Location | |||||||||
| Address1: | 41002 COUNTY CENTER DR STE 320 | ||||||||
| Address2: | |||||||||
| City: | TEMECULA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925916027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9516006355 | ||||||||
| FaxNumber: | 9516006365 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2019 | ||||||||
| LastUpdateDate: | 07/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.