Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ERICA RENE GRAHAM-BULLOCK
Active Sole ProprietorIntellectual Disabilities Residential Treatment Facility · PERRIS, CA
Registration Details
- NPI Number
- 1063284875
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 25, 2023 (2.4895354996329 yrs)
- Last Updated
- Oct 25, 2023
- License
-
331881331 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3656 GINGER STPERRIS, CA, 925717825Browse CA providers · Browse ZIP 92571
- Phone
- 8188181817
- Primary Specialty
-
Intellectual Disabilities Residential Treatment Facility
320600000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.