Provider Demographics
NPI:1528769619
Name:GOLDEN, ERICA TAYLOR (FNP)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:TAYLOR
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 BERNARD ST UNIT 207
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-5783
Mailing Address - Country:US
Mailing Address - Phone:559-246-0381
Mailing Address - Fax:
Practice Address - Street 1:401 BERNARD ST UNIT 207
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-5783
Practice Address - Country:US
Practice Address - Phone:559-246-0381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95021490363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily