Provider Demographics
NPI:1205042819
Name:SCHMIDT, PAULA (ASW 69336)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:ASW 69336
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 397
Mailing Address - Street 2:
Mailing Address - City:YREKA
Mailing Address - State:CA
Mailing Address - Zip Code:96097-0397
Mailing Address - Country:US
Mailing Address - Phone:530-842-3455
Mailing Address - Fax:530-842-7917
Practice Address - Street 1:1833 S OREGON ST
Practice Address - Street 2:
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097-3446
Practice Address - Country:US
Practice Address - Phone:530-842-3455
Practice Address - Fax:530-842-7917
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2016-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 69336101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health