1205054418 NPI number — PROF. OFELIA KITTY SCHEMENAUER M.S., MFT

Table of content: PROF. OFELIA KITTY SCHEMENAUER M.S., MFT (NPI 1205054418)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205054418 NPI number — PROF. OFELIA KITTY SCHEMENAUER M.S., MFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHEMENAUER
Provider First Name:
OFELIA
Provider Middle Name:
KITTY
Provider Name Prefix Text:
PROF.
Provider Name Suffix Text:
Provider Credential Text:
M.S., MFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHEMENAUER
Provider Other First Name:
KITTY
Provider Other Middle Name:
L.
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S., MFT
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1205054418
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:
2909 BLUE SPRUCE CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
THOUSAND OAKS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91360-6303
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-493-0115
Provider Business Mailing Address Fax Number:
805-493-0115

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3585 MAPLE ST
Provider Second Line Business Practice Location Address:
#266
Provider Business Practice Location Address City Name:
VENTURA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93003-3504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-789-2010
Provider Business Practice Location Address Fax Number:
818-986-0724
Provider Enumeration Date:
04/23/2007

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: 106H00000X , with the licence number:  MFT28081 , 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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