Provider Demographics
NPI:1265681977
Name:CHANDLER-ECKHARDT, CATHLEEN
Entity Type:Individual
Prefix:MRS
First Name:CATHLEEN
Middle Name:
Last Name:CHANDLER-ECKHARDT
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CATHLEEN
Other - Middle Name:
Other - Last Name:CHANDLER-ECKHARDT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP/ PA
Mailing Address - Street 1:PO BOX 1870
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95077-1870
Mailing Address - Country:US
Mailing Address - Phone:831-728-0222
Mailing Address - Fax:831-707-2777
Practice Address - Street 1:204 E BEACH ST
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-4809
Practice Address - Country:US
Practice Address - Phone:831-728-0222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13083363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical