Provider Demographics
NPI:1912478249
Name:EHLERT, ANGELYNA CHRISTINE
Entity Type:Individual
Prefix:
First Name:ANGELYNA
Middle Name:CHRISTINE
Last Name:EHLERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1337 HOWE AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-3305
Mailing Address - Country:US
Mailing Address - Phone:916-564-5010
Mailing Address - Fax:
Practice Address - Street 1:1337 HOWE AVE STE 107
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-3305
Practice Address - Country:US
Practice Address - Phone:916-564-5010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other