Provider Demographics
NPI:1174342208
Name:WATERHOUSE, ERIN
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:WATERHOUSE
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 1:4914 ANTIOCH ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-5520
Mailing Address - Country:US
Mailing Address - Phone:510-673-0860
Mailing Address - Fax:
Practice Address - Street 1:4210 TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-6337
Practice Address - Country:US
Practice Address - Phone:510-657-2350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool