MEDICARE: MRS. CHRISTINE LUCILE KLINKBY-CERDA LVN

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	164X00000X	Licensed Vocational Nurse	VN68154	CA

General Provider Information

NPI Number	:	1548318678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINE LUCILE KLINKBY-CERDA LVN

Provider Business Mailing Address
First Line	:	4656 N BOND AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93726-1610
Country	:	US
Telephone Number	:	559-226-7361
Fax Number	:	559-225-8467

Provider Business Practice Location Address
First Line	:	4656 N BOND AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93726-1610
Country	:	US
Telephone Number	:	559-226-7361
Fax Number	:	559-225-8467

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

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	07/08/2007

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