Provider Demographics
NPI:1255432225
Name:ERNST, CHRISTIN ANN (DPT)
Entity type:Individual
Prefix:DR
First Name:CHRISTIN
Middle Name:ANN
Last Name:ERNST
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9855 ERMA RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-3001
Mailing Address - Country:US
Mailing Address - Phone:858-549-7111
Mailing Address - Fax:858-549-9240
Practice Address - Street 1:10806 WILLOW CT
Practice Address - Street 2:SUITE 2
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-2428
Practice Address - Country:US
Practice Address - Phone:858-217-5837
Practice Address - Fax:858-217-5935
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT29748225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT29748AMedicare ID - Type Unspecified
CAW17215Medicare PIN
CAW17215AMedicare PIN
CAEY096XMedicare PIN
CAEY096YMedicare PIN