Provider Demographics
NPI:1164109138
Name:SCHINDELMANN, MARIA LUCIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:LUCIA
Last Name:SCHINDELMANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 GLENNEYRE ST
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-3270
Mailing Address - Country:US
Mailing Address - Phone:949-313-5200
Mailing Address - Fax:
Practice Address - Street 1:1555 GLENNEYRE ST
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-3270
Practice Address - Country:US
Practice Address - Phone:949-322-2740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACI39400723101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)