=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417254350
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIE CUGINI SCHUR PHD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/11/2011
-----------------------------------------------------
Last Update Date | 09/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 669 QUINCY AVE
-----------------------------------------------------
City | LONG BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90814-1818
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-600-8281
-----------------------------------------------------
Fax | 877-836-4566
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 440 N BARRANCA AVE # 5633
-----------------------------------------------------
City | COVINA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91723-1722
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-600-8281
-----------------------------------------------------
Fax | 877-836-4566
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | PSY 23998
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | 6755
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------