Christel N Backert, FNP

Individual provider Active NPI Nurse Practitioner · Lathrop, CA

NPI 1124254842 · NPPES record last updated Jul 29, 2025

Key facts

NPI
1124254842
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
18958 (CA)
Practice address
15810 S. Harland Road Ste B
Lathrop, CA 95330-9476
Phone
(209) 229-4455
Fax
(209) 215-0285
NPI assigned
Jun 9, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
18958CAMDAcupuncturist
27454CAMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 18958 CA Yes

Addresses

Primary practice location

15810 S. Harland Road Ste B
Lathrop, CA 95330-9476

Mailing address

15810 S. Harland Road Ste B
Lathrop, CA 95330-9476
Phone (209) 229-4455

Other providers in Lathrop, CA

All providers in Lathrop, CA · Nurse Practitioner in California

Sources for this page

Verify at the official NPI Registry.