Healthcare Provider Details

I. General information

NPI: 1275843229
Provider Name (Legal Business Name): PAULETTE SCHAFIR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2010
Last Update Date: 10/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 W MACARTHUR BLVD BROADWAY MOB, 2ND FLOOR
OAKLAND CA
94611-5642
US

IV. Provider business mailing address

280 W MACARTHUR BLVD BROADWAY MOB, 2ND FLOOR
OAKLAND CA
94611-5642
US

V. Phone/Fax

Practice location:
  • Phone: 510-752-5684
  • Fax: 510-752-6561
Mailing address:
  • Phone: 510-752-5684
  • Fax: 510-752-6561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number4576
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: