1881615185 NPI number — DR. GAIL L. SCHAPER-GORDON PH.D,

Table of content: DR. GAIL L. SCHAPER-GORDON PH.D, (NPI 1881615185)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881615185 NPI number — DR. GAIL L. SCHAPER-GORDON PH.D,

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHAPER-GORDON
Provider First Name:
GAIL
Provider Middle Name:
L.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D,
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881615185
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1912 KAWEAH DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PASADENA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91105-3604
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-259-9449
Provider Business Mailing Address Fax Number:
323-344-0008

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4529 ANGELES CREST HWY
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
LA CANADA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91011-3247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-368-0079
Provider Business Practice Location Address Fax Number:
323-344-0008
Provider Enumeration Date:
07/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  PSY8898 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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