Healthcare Provider Details

I. General information

NPI: 1750828877
Provider Name (Legal Business Name): ANJONE DORA SCHOT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2017
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4750 PALM AVE
RIVERSIDE CA
92501-4012
US

IV. Provider business mailing address

2743 ORANGE ST
RIVERSIDE CA
92501-2538
US

V. Phone/Fax

Practice location:
  • Phone: 951-686-0021
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberCNA00725505
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCI45081124
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: