Healthcare Provider Details

I. General information

NPI: 1043852486
Provider Name (Legal Business Name): MADELEINE RENEE SCHOCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2019
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17071 VENTURA BLVD STE 103
ENCINO CA
91316-4142
US

IV. Provider business mailing address

17071 VENTURA BLVD STE 103
ENCINO CA
91316-4142
US

V. Phone/Fax

Practice location:
  • Phone: 818-232-4884
  • Fax: 818-232-4894
Mailing address:
  • Phone: 818-232-4884
  • Fax: 818-232-4894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number309208
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: