Provider Demographics
NPI:1447401781
Name:SCHERLIS, BRENDA (NP)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:SCHERLIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:
Other - Last Name:AHLSTEDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 1371
Mailing Address - Street 2:54910 PINE CREST AVE
Mailing Address - City:IDYLLWILD
Mailing Address - State:CA
Mailing Address - Zip Code:92549-1371
Mailing Address - Country:US
Mailing Address - Phone:951-659-9912
Mailing Address - Fax:951-468-4202
Practice Address - Street 1:54910 PINE CREST AVE
Practice Address - Street 2:
Practice Address - City:IDYLLWILD
Practice Address - State:CA
Practice Address - Zip Code:92549-1371
Practice Address - Country:US
Practice Address - Phone:951-659-9912
Practice Address - Fax:951-468-4202
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6313363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily