1750411377 NPI number — MS. DONNA SCHUMACHER BLASCHKE MSW LCSW

Table of content: MS. DONNA SCHUMACHER BLASCHKE MSW LCSW (NPI 1750411377)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750411377 NPI number — MS. DONNA SCHUMACHER BLASCHKE MSW LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BLASCHKE
Provider First Name:
DONNA
Provider Middle Name:
SCHUMACHER
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHUMACHER
Provider Other First Name:
DONNA
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1750411377
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 255472
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SACRAMENTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95865-5472
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-734-3497
Provider Business Mailing Address Fax Number:
916-734-0415

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2315 STOCKTON BLVD
Provider Second Line Business Practice Location Address:
PSSB 1300 UC DAVIS MEDICAL CENTER
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-734-3497
Provider Business Practice Location Address Fax Number:
916-734-0415
Provider Enumeration Date:
03/06/2007

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: 1041C0700X , with the licence number:  LCS21619 , 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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