Healthcare Provider Details

I. General information

NPI: 1568947141
Provider Name (Legal Business Name): CHRISTINE MARIE EHRLER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE MARIE FUNKHOUSER RN

II. Dates (important events)

Enumeration Date: 09/28/2018
Last Update Date: 09/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1904 RICHLAND AVE BLDG F
CERES CA
95307-4562
US

IV. Provider business mailing address

1917 MEMORIAL DR
CERES CA
95307-1826
US

V. Phone/Fax

Practice location:
  • Phone: 209-525-7444
  • Fax: 209-541-2556
Mailing address:
  • Phone: 209-525-7444
  • Fax: 209-541-2556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number569293
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: