Provider Demographics
NPI:1538874771
Name:SCHNEIDER, TIMOTHY JONATHON (DPT)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JONATHON
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1451 ROCKY RIDGE DR APT 1901
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3014
Mailing Address - Country:US
Mailing Address - Phone:916-724-9736
Mailing Address - Fax:
Practice Address - Street 1:5945 PACIFIC ST
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-3422
Practice Address - Country:US
Practice Address - Phone:916-659-1020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA303477225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist