Healthcare Provider Details

I. General information

NPI: 1558292615
Provider Name (Legal Business Name): CHARLES SCHWARTZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3371 PARKER HILL RD
SANTA ROSA CA
95404-1732
US

IV. Provider business mailing address

3419 VALLE VERDE DR
NAPA CA
94558-2414
US

V. Phone/Fax

Practice location:
  • Phone: 707-535-0289
  • Fax:
Mailing address:
  • Phone: 707-299-8250
  • Fax: 707-635-8215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: