Healthcare Provider Details

I. General information

NPI: 1114009669
Provider Name (Legal Business Name): R ALANA SCHULLER MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: R. ALANA SCHULLER MFT

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 09/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

767 ACADEMY DR
SOLANA BEACH CA
92075-2031
US

IV. Provider business mailing address

767 ACADEMY DR
SOLANA BEACH CA
92075-2031
US

V. Phone/Fax

Practice location:
  • Phone: 619-692-9696
  • Fax: 858-793-4406
Mailing address:
  • Phone: 619-692-9696
  • Fax: 858-793-4406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC19752
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: