Provider Demographics
NPI:1225403223
Name:SCHNEIDER, KRISTIN GRACE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:GRACE
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:PHD
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 1662
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93942-1662
Mailing Address - Country:US
Mailing Address - Phone:831-747-7037
Mailing Address - Fax:831-200-0930
Practice Address - Street 1:629 MARTIN ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4437
Practice Address - Country:US
Practice Address - Phone:831-747-7037
Practice Address - Fax:831-200-0930
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-02
Last Update Date:2016-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 24733103TB0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral