Provider Demographics
NPI:1174242580
Name:CAINE, ERICA CATHERINE (ATC)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:CATHERINE
Last Name:CAINE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:CATHERINE
Other - Last Name:WILLIAMSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:3703 ARTISTRY WAY
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-6915
Mailing Address - Country:US
Mailing Address - Phone:405-501-3101
Mailing Address - Fax:
Practice Address - Street 1:1055 FOWLER AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-2062
Practice Address - Country:US
Practice Address - Phone:405-501-3101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
BOC20000149952255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
200014995OtherBOARD OF CERTIFICATION