Provider Demographics
NPI:1356493209
Name:SCHUITEVOERDER, NEIL (PHD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:
Last Name:SCHUITEVOERDER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21241 VENTURA BLVD
Mailing Address - Street 2:SUITE 269
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2108
Mailing Address - Country:US
Mailing Address - Phone:818-348-2348
Mailing Address - Fax:
Practice Address - Street 1:21241 VENTURA BLVD
Practice Address - Street 2:SUITE 269
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2108
Practice Address - Country:US
Practice Address - Phone:818-348-2348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11859103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP11859Medicare ID - Type Unspecified