1841477221 NPI number — DR. REGINA MARY SCHAEFER L.M.F.T.

Table of content: DR. REGINA MARY SCHAEFER L.M.F.T. (NPI 1841477221)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841477221 NPI number — DR. REGINA MARY SCHAEFER L.M.F.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHAEFER
Provider First Name:
REGINA
Provider Middle Name:
MARY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
L.M.F.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCCONNELL
Provider Other First Name:
REGINA
Provider Other Middle Name:
MARY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
L.M.F.T.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1841477221
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
71 W SIERRA MADRE BLVD
Provider Second Line Business Mailing Address:
SIERRA MADRE
Provider Business Mailing Address City Name:
SIERRA MADRE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91024-2462
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-833-0945
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
71 W SIERRA MADRE BLVD
Provider Second Line Business Practice Location Address:
SIERRA MADRE
Provider Business Practice Location Address City Name:
SIERRA MADRE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91024-2462
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-833-0945
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/28/2008

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:  MFC29706 , 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)

  • Identifier: 1332351 . This is a "CAQH" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".