Provider Demographics
NPI:1346011434
Name:SCHUMANN, SAMANTHA MONTEVERDE (MA)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:MONTEVERDE
Last Name:SCHUMANN
Suffix:
Gender:F
Credentials:MA
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 88429
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90009-8429
Mailing Address - Country:US
Mailing Address - Phone:424-903-9818
Mailing Address - Fax:
Practice Address - Street 1:2525 W WASHINGTON BLVD STE 104
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90018-1271
Practice Address - Country:US
Practice Address - Phone:234-759-4113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA123990106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist