Basic Information
| Provider Information | |||||||||
| NPI: | 1215294517 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WALLENDER | ||||||||
| FirstName: | ERIKA | ||||||||
| MiddleName: | KAREN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 513 PARNASSUS AVE | ||||||||
| Address2: | RM S-380 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941432205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153224916 | ||||||||
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| Practice Location | |||||||||
| Address1: | 209 LIGHT HL | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372320001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153224916 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2012 | ||||||||
| LastUpdateDate: | 06/16/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.