Provider Demographics
NPI:1063850873
Name:SCHAPPER, GARY EDWIN (LMFT)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:EDWIN
Last Name:SCHAPPER
Suffix:
Gender:M
Credentials:LMFT
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 66576
Mailing Address - Street 2:
Mailing Address - City:SCOTTS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95067-6576
Mailing Address - Country:US
Mailing Address - Phone:831-566-6349
Mailing Address - Fax:
Practice Address - Street 1:11011 CRENSHAW BLVD STE 204
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90303-6339
Practice Address - Country:US
Practice Address - Phone:323-786-9757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 52939106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist