NPI 1063284875

Erica Rene Graham-Bullock

Practitioner Intellectual and/or Developmental Disabilities Residential Treatment Facility Perris, CA

Practice location

Address: 3656 Ginger St, Perris, CA 92571-7825
Phone: (818) 818-1817

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X Licence 331881331 (CA)

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in California →

Registry record

NPI: 1063284875
Entity type: Individual
Sex (as registered): Female
NPI issued: 25 Oct 2023
Record last updated: 25 Oct 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.