Provider Demographics
NPI:1699272161
Name:SCHMIDT, CHRISTINA LYNNEA
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LYNNEA
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 AVIATION WAY
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-2053
Mailing Address - Country:US
Mailing Address - Phone:831-728-0222
Mailing Address - Fax:
Practice Address - Street 1:195 AVIATION WAY STE 200
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-2059
Practice Address - Country:US
Practice Address - Phone:831-728-0222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95136393163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse