Healthcare Provider Details

I. General information

NPI: 1285125617
Provider Name (Legal Business Name): JENNIFER E. SCHOOLEY PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER LOTZ PSYD

II. Dates (important events)

Enumeration Date: 05/22/2018
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1144 SONOMA AVE STE 104
SANTA ROSA CA
95405-4812
US

IV. Provider business mailing address

1144 SONOMA AVE STE 104
SANTA ROSA CA
95405-4812
US

V. Phone/Fax

Practice location:
  • Phone: 707-901-7900
  • Fax:
Mailing address:
  • Phone: 707-901-7900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number28550
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: