Provider Demographics
NPI:1184006058
Name:SCHROEDER, ROXY
Entity Type:Individual
Prefix:
First Name:ROXY
Middle Name:
Last Name:SCHROEDER
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 1:2081 MONTAUK CT
Mailing Address - Street 2:
Mailing Address - City:DISCOVERY BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94505-9119
Mailing Address - Country:US
Mailing Address - Phone:925-727-9386
Mailing Address - Fax:
Practice Address - Street 1:1959-1967 SOLANO WAY
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520
Practice Address - Country:US
Practice Address - Phone:925-676-9768
Practice Address - Fax:925-679-9700
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program