Provider Demographics
NPI:1801239355
Name:SCHREIBER, BENJAMIN JOSHUA (CADC II)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:JOSHUA
Last Name:SCHREIBER
Suffix:
Gender:M
Credentials:CADC II
Other - Prefix:
Other - First Name:JOSHUA
Other - Middle Name:BENJAMIN
Other - Last Name:SCHREIBER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5714 NEWCASTLE AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-1053
Mailing Address - Country:US
Mailing Address - Phone:323-459-6495
Mailing Address - Fax:
Practice Address - Street 1:5714 NEWCASTLE AVE
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-1053
Practice Address - Country:US
Practice Address - Phone:323-459-6495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA4570409101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)