Healthcare Provider Details

I. General information

NPI: 1205603388
Provider Name (Legal Business Name): SHELBY RENE SCHMADER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2023
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40820 WINCHESTER RD STE 32
TEMECULA CA
92591-5526
US

IV. Provider business mailing address

31872 QUILL CT
MENIFEE CA
92584-3831
US

V. Phone/Fax

Practice location:
  • Phone: 951-583-3068
  • Fax:
Mailing address:
  • Phone: 951-970-9879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95028294
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: