Provider Demographics
NPI:1366453094
Name:ERNI, GUILLERMINA W (MD)
Entity Type:Individual
Prefix:DR
First Name:GUILLERMINA
Middle Name:W
Last Name:ERNI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7250 PRINCETON PL
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-6012
Mailing Address - Country:US
Mailing Address - Phone:408-842-7969
Mailing Address - Fax:
Practice Address - Street 1:219 N SANBORN RD
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93905-2218
Practice Address - Country:US
Practice Address - Phone:831-757-1365
Practice Address - Fax:831-757-2824
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39788208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A397880Medicaid
CA00A397880Medicare ID - Type Unspecified
CA00A397880Medicaid