MEDICARE: TERESA SCHMITZ MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041S0200X	School Social Worker

General Provider Information

NPI Number	:	1124400445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA SCHMITZ MSW

Provider Business Mailing Address
First Line	:	2011 LITTLE ORCHARD ST
Second Line	:
City	:	SAM JOSE
State	:	CA
Zip	:	95125
Country	:	US
Telephone Number	:	408-603-3535
Fax Number	:

Provider Business Practice Location Address
First Line	:	2011 LITTLE ORCHARD ST
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95125-1031
Country	:	US
Telephone Number	:	408-603-3535
Fax Number	:	831-794-1816

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2015
Last Update Date	:	07/11/2017

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