Provider Demographics
NPI:1417254350
Name:SCHUR, MARIE CUGINI (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:CUGINI
Last Name:SCHUR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:MARIE
Other - Middle Name:CUGINI
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:5975 ENTRADA AVE
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-4223
Mailing Address - Country:US
Mailing Address - Phone:805-250-4716
Mailing Address - Fax:
Practice Address - Street 1:10333 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-5808
Practice Address - Country:US
Practice Address - Phone:805-468-2947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-11
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 23998103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical