Provider Demographics
NPI:1538231667
Name:SCHULZ, CHRISTINE YVONNE (LSCW)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:YVONNE
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:LSCW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6470 LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-4229
Mailing Address - Country:US
Mailing Address - Phone:805-466-1864
Mailing Address - Fax:805-461-0587
Practice Address - Street 1:6470 LEWIS AVE
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-4229
Practice Address - Country:US
Practice Address - Phone:805-466-1864
Practice Address - Fax:805-461-0587
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASW14963104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW14963Medicare ID - Type Unspecified