Healthcare Provider Details

I. General information

NPI: 1780815936
Provider Name (Legal Business Name): MR. TOM PAUL SCHMIDT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2009
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 NORTHGATE DR FAMILY SERVICE AGENCY OF MARIN
SAN RAFAEL CA
94903-3680
US

IV. Provider business mailing address

PO BOX 5158
NOVATO CA
94948-5158
US

V. Phone/Fax

Practice location:
  • Phone: 415-491-5700
  • Fax: 415-491-5750
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: