MEDICARE: DR. JEFFREY LEE SCHNELL PH.D.

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	103T00000X	Psychologist	PSY21030	CA

General Provider Information

NPI Number	:	1407962004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY LEE SCHNELL PH.D.

Provider Business Mailing Address
First Line	:	9400 BRIGHTON WAY
Second Line	:	SUITE 407
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-4703
Country	:	US
Telephone Number	:	310-849-5162
Fax Number	:

Provider Business Practice Location Address
First Line	:	9400 BRIGHTON WAY
Second Line	:	SUITE 407
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-4703
Country	:	US
Telephone Number	:	310-849-5162
Fax Number	:

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

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	07/08/2007

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