MEDICARE: CHRISTINE ANN SCHEUERMANN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	167G00000X	Licensed Psychiatric Technician	41623	CA

General Provider Information

NPI Number	:	1093337511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE ANN SCHEUERMANN

Provider Business Mailing Address
First Line	:	1447 REPORT AVE
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95205-3030
Country	:	US
Telephone Number	:	209-346-8302
Fax Number	:

Provider Business Practice Location Address
First Line	:	1447 REPORT AVE
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95205-3030
Country	:	US
Telephone Number	:	209-346-8302
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2020
Last Update Date	:	05/07/2020

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