Healthcare Provider Details

I. General information

NPI: 1558274050
Provider Name (Legal Business Name): CHANNEL SCHERER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 CALLE CONEJO
ALPINE CA
91901-2191
US

IV. Provider business mailing address

124 CALLE CONEJO
ALPINE CA
91901-2191
US

V. Phone/Fax

Practice location:
  • Phone: 660-728-0600
  • Fax:
Mailing address:
  • Phone: 660-728-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95453374
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: