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NPI Code Detail

MEDICARE: KRISTEN MARIE SCHNEIDER LCSW

MEDICARE: KRISTEN MARIE SCHNEIDER LCSW
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
1101YP2500XProfessional Counselor
21041C0700XClinical Social Worker87295CA
3101Y00000XCounselor

General Provider Information

NPI Number : 1578963591
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN MARIE SCHNEIDER LCSW
Provider Business Mailing Address
First Line : 326 LAS PALMAS AVE
Second Line :
City : MODESTO
State : CA
Zip : 95354-1442
Country : US
Telephone Number : 209-661-3519
Fax Number :
Provider Business Practice Location Address
First Line : 447 SUTTER ST STE 405
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94108-4618
Country : US
Telephone Number : 209-661-3519
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2014
Last Update Date : 04/22/2024

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