Individual provider · Type 1 NPI

Jacob Ericksen

Student in an Organized Health Care Education/Training Program · Tarzana, CA

NPI number 1881531713 Active

Practice location

18646 Oxnard St
Tarzana, CA 91356-1486

Call (888) 777-8565 Map

Mailing address

2500 Wilshire Blvd Ph 4
Los Angeles, CA 90057-5431

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1881531713

Jacob Ericksen's National Provider Identifier is 1881531713, issued on Apr 29, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Tarzana, CA. The record was last updated on Apr 29, 2026.