Provider Demographics
NPI:1548728355
Name:SCHAFER, ANN KAREN (PHD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:KAREN
Last Name:SCHAFER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1252
Mailing Address - Street 2:
Mailing Address - City:MEADOW VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:95722-1252
Mailing Address - Country:US
Mailing Address - Phone:916-813-4315
Mailing Address - Fax:530-492-3290
Practice Address - Street 1:4112 CRESTLINE AVE
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-7103
Practice Address - Country:US
Practice Address - Phone:916-813-4315
Practice Address - Fax:530-492-3290
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15071103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical