Provider Demographics
NPI:1174316798
Name:LLANOS, ERIKA MARIBEL
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:MARIBEL
Last Name:LLANOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:861 N HAMILTON BLVD
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91768-2929
Mailing Address - Country:US
Mailing Address - Phone:909-802-5161
Mailing Address - Fax:
Practice Address - Street 1:21505 NORWALK BLVD
Practice Address - Street 2:
Practice Address - City:HAWAIIAN GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90716-1121
Practice Address - Country:US
Practice Address - Phone:562-916-7581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15759101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)