Provider Demographics
NPI:1275242919
Name:SHAKER, CHRISTINE (RN)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTINE
Middle Name:
Last Name:SHAKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2037 DARLINGTON CT
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-4228
Mailing Address - Country:US
Mailing Address - Phone:619-342-5255
Mailing Address - Fax:
Practice Address - Street 1:555 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2289
Practice Address - Country:US
Practice Address - Phone:619-260-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95300070163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse