Healthcare Provider Details

I. General information

NPI: 1124982087
Provider Name (Legal Business Name): KAYLA HAMILTON EHRENBERGER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2151 MEEKER AVE
RICHMOND CA
94804-6410
US

IV. Provider business mailing address

173 CAPRICE CIR
HERCULES CA
94547-2082
US

V. Phone/Fax

Practice location:
  • Phone: 510-231-5922
  • Fax:
Mailing address:
  • Phone: 303-502-7471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number61451428
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number91709
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: