Basic Information
| Provider Information | |||||||||
| NPI: | 1972637999 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MANCILLA | ||||||||
| FirstName: | ERIKA | ||||||||
| MiddleName: | CARDENAS | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16415 SOUTH COLORADO AVE. SUITE. 305 | ||||||||
| Address2: | |||||||||
| City: | PARAMOUNT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5624458177 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12440 E. FIRESTONE BLVD. SUITE 316 | ||||||||
| Address2: | |||||||||
| City: | NORWALK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906505035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5628643722 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2007 | ||||||||
| LastUpdateDate: | 05/17/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 106H00000X | MFC52977 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.