MEDICARE: MRS. LEONORE CECILIA SCHUETZ M.F.T.

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	106H00000X	Marriage & Family Therapist	43883	CA

General Provider Information

NPI Number	:	1730397506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LEONORE CECILIA SCHUETZ M.F.T.

Provider Business Mailing Address
First Line	:	1720 E LOS ANGELES AVE
Second Line	:	SUITE 222
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065-2033
Country	:	US
Telephone Number	:	805-522-8444
Fax Number	:	805-522-8444

Provider Business Practice Location Address
First Line	:	1720 E LOS ANGELES AVE
Second Line	:	SUITE 222
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065-2033
Country	:	US
Telephone Number	:	805-522-8444
Fax Number	:	805-522-8444

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

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	06/05/2008

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