Provider Demographics
NPI:1902790199
Name:BRAVO CASTILLO, ERICA CHRISTINA (IBCLC)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:CHRISTINA
Last Name:BRAVO CASTILLO
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4437 VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92509-2969
Mailing Address - Country:US
Mailing Address - Phone:951-347-4524
Mailing Address - Fax:
Practice Address - Street 1:4437 VERNON AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92509-2969
Practice Address - Country:US
Practice Address - Phone:951-347-4524
Practice Address - Fax:951-347-4524
Is Sole Proprietor?:No
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-17964174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN