MEDICARE: MRS. JENNIFER ANN SCHMIDT MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	42544	CA

General Provider Information

NPI Number	:	1730237033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER ANN SCHMIDT MFT

Provider Business Mailing Address
First Line	:	15161 CHERBOURG AVE
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92604-3119
Country	:	US
Telephone Number	:	949-262-0679
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 E MCFADDEN AVE
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92705-4736
Country	:	US
Telephone Number	:	949-262-0679
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	07/08/2007

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