1437413226 NPI number — MRS. MELISSA JOAN SCHULZ MS, BCBA

Table of content: MRS. MELISSA JOAN SCHULZ MS, BCBA (NPI 1437413226)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437413226 NPI number — MRS. MELISSA JOAN SCHULZ MS, BCBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHULZ
Provider First Name:
MELISSA
Provider Middle Name:
JOAN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS, BCBA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DRAGO
Provider Other First Name:
MELISSA
Provider Other Middle Name:
JOAN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1437413226
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3445 LITTLE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FREMONT
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94538-2914
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-629-1246
Provider Business Mailing Address Fax Number:
510-373-3715

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
424 PENINSULA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN MATEO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94401-1653
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-538-8365
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/27/2012

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: 103K00000X , with the licence number:  1096412 , 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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