1497067755 NPI number — DR. JOHN L SCHAEFFER, INC

Table of content: (NPI 1497067755)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497067755 NPI number — DR. JOHN L SCHAEFFER, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. JOHN L SCHAEFFER, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CALIFORNIA TELEPSYCHIATRISTS
Provider Other Organization Name Type Code:
3
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:
1497067755
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/02/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3308 EL CAMINO AVE
Provider Second Line Business Mailing Address:
SUITE 300-136
Provider Business Mailing Address City Name:
SACRAMENTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95821-6327
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-377-8163
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3308 EL CAMINO AVE
Provider Second Line Business Practice Location Address:
SUITE 300-136
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95821-6327
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-377-8163
Provider Business Practice Location Address Fax Number:
888-370-2829
Provider Enumeration Date:
07/02/2010

Additional Information

Authorized Official

Authorized Official Last Name:
SCHAEFFER
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
800-377-8163

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  20A9536 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: A-1243-03 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: DR38750 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0804X , with the licence number: 20A9536 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2084P0804X , with the licence number: A-1243-03 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0804X , with the licence number: DR38750 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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