Provider Demographics
NPI:1447084785
Name:ERRICO, PAOLO SAL
Entity type:Individual
Prefix:
First Name:PAOLO
Middle Name:SAL
Last Name:ERRICO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9221 HELIX MESA WAY
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-1210
Mailing Address - Country:US
Mailing Address - Phone:818-815-9944
Mailing Address - Fax:
Practice Address - Street 1:9221 HELIX MESA WAY
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-1210
Practice Address - Country:US
Practice Address - Phone:818-815-9944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician