Provider Demographics
NPI:1487999579
Name:G D SHOENBERGER, INC.
Entity type:Organization
Organization Name:G D SHOENBERGER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:DEACON
Authorized Official - Last Name:SHOENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:775-219-9596
Mailing Address - Street 1:377 CALIENTE ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-2729
Mailing Address - Country:US
Mailing Address - Phone:775-448-6828
Mailing Address - Fax:877-304-7727
Practice Address - Street 1:636 LANDER ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-1512
Practice Address - Country:US
Practice Address - Phone:775-448-6828
Practice Address - Fax:877-304-7727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-30
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0569103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty