1134624737 NPI number — MRS. ROMINA MARIE SCHNELLE LMFT 123169

Table of content: MRS. ROMINA MARIE SCHNELLE LMFT 123169 (NPI 1134624737)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134624737 NPI number — MRS. ROMINA MARIE SCHNELLE LMFT 123169

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHNELLE
Provider First Name:
ROMINA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMFT 123169
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROSERO
Provider Other First Name:
ROMINA
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMFT 123169
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1134624737
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/03/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
201 E CENTER ST
Provider Second Line Business Mailing Address:
STE 112 PMB 3446
Provider Business Mailing Address City Name:
ANAHEIM
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92805-1606
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
657-201-9166
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 E CENTER ST
Provider Second Line Business Practice Location Address:
STE 112 PMB 3446
Provider Business Practice Location Address City Name:
ANAHEIM
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92805-1606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-300-6572
Provider Business Practice Location Address Fax Number:
866-420-8994
Provider Enumeration Date:
03/26/2018

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: 106H00000X , with the licence number:  123169 , 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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