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Erika Dominique Vicente

Pediatrics

Allopathic & Osteopathic Physicians

PECOS Enrollment

This provider is enrolled in PECOS as ERIKA VICENTE.

Based on the most recent information from CMS, provider Erika Dominique Vicente is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1174027791
Provider Type
Individual
Full Name
Vicente, Erika Dominique
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
3/20/2018
Last Updated
6/25/2024

Contact Information

Practice Location

725 Welch Rd, Palo Alto, CA 94304-1601

(650) 497-8000

Unlisted Fax

Mailing Location

725 Welch Rd, Palo Alto, CA 94304-1601

(650) 497-8000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208000000X Primary	Description Pediatrics Allopathic & Osteopathic Physicians	License A165676 California
Code 208000000X	Description Pediatrics Allopathic & Osteopathic Physicians	License DR.0066299 Colorado

Erika Dominique Vicente

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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