Provider Demographics
NPI:1437235991
Name:SCHALET, RANDI (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RANDI
Middle Name:
Last Name:SCHALET
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 SOUTHAMPTON RD STE 102
Mailing Address - Street 2:
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-2075
Mailing Address - Country:US
Mailing Address - Phone:707-750-5721
Mailing Address - Fax:
Practice Address - Street 1:26 CUMMINS HIGHWAY
Practice Address - Street 2:SUITE 2
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131
Practice Address - Country:US
Practice Address - Phone:617-327-1942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7268103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA348602OtherMAGELLAN AETNA
MAW05714OtherBLUE CROSS
MA0527092Medicaid
MA348602OtherMAGELLAN AETNA
W50269Medicare UPIN