Healthcare Provider Details
I. General information
NPI: 1053478750
Provider Name (Legal Business Name): JAMES L SCHAEFER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/02/2007
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
22231 MULHOLLAND HWY STE 106
CALABASAS CA
91302-5178
US
IV. Provider business mailing address
22231 MULHOLLAND HWY STE 106
CALABASAS CA
91302-5178
US
V. Phone/Fax
- Phone: 818-222-9300
- Fax: 818-223-8224
- Phone: 818-222-9300
- Fax: 818-223-8224
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JAMES
L
SCHAEFER
Title or Position: DIRECTOR
Credential: PSY.D.
Phone: 818-222-9300