Provider Demographics
NPI:1023897675
Name:MACIAS, ERIKA SIERRA (COTA/L)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:SIERRA
Last Name:MACIAS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10433 SUSIE PL
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-4912
Mailing Address - Country:US
Mailing Address - Phone:562-480-2895
Mailing Address - Fax:
Practice Address - Street 1:10433 SUSIE PL
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-4912
Practice Address - Country:US
Practice Address - Phone:562-480-2895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3279224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant