Healthcare Provider Details

I. General information

NPI: 1609226372
Provider Name (Legal Business Name): SAMANTHA EDEN SCHAEFER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2016
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3021 CITRUS CIRCLE ST. 240
WALNUT CREEK CA
94598
US

IV. Provider business mailing address

3021 CITRUS CIR ST. 240
WALNUT CREEK CA
94598-2692
US

V. Phone/Fax

Practice location:
  • Phone: 925-317-1620
  • Fax: 925-357-8039
Mailing address:
  • Phone: 925-317-1620
  • Fax: 925-357-8039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number95356
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: