Healthcare Provider Details

I. General information

NPI: 1043144330
Provider Name (Legal Business Name): MRS. ROSALIA MARIE SCHMIDT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1995 SHADY BROOK WAY
UPLAND CA
91784-7430
US

IV. Provider business mailing address

1995 SHADY BROOK WAY
UPLAND CA
91784-7430
US

V. Phone/Fax

Practice location:
  • Phone: 909-994-4351
  • Fax:
Mailing address:
  • Phone: 909-994-4351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: