Erica Ann Wicke

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

47892 Issued in CA

Practice address

1852 Barrywood Ave
San Pedro, CA 90731-1215

Phone

(714) 273-8580

NPI assigned

Jan 19, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 31, 2025 through May 31, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Erica a Wicke M.a. Licensed Marriage and Family Therapist Inc.

  • Marriage & Family Therapist
  • San Pedro, CA
  • NPI 1326602855
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1263859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368576000000",
    "number": "1013248871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1852 BARRYWOOD AVE",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907311215",
            "telephone_number": "714-273-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1852 BARRYWOOD AVE",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907311215",
            "telephone_number": "714-273-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKE",
        "first_name": "ERICA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-19",
        "last_updated": "2013-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "47892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• West Coast Diagnostic Services
• Western Dental Services, Inc.
• Westhout MD Inc
• Westhout MD Inc
• White Point Care Center LLC
• Grace Puddoc Wilbur, LVN
• Belen Williams, LCSW
• Darryl Williams
• Jaci Williams, RN
• Scott Williams, CADC II

• Marriage & Family Therapist in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.