Provider Demographics
NPI:1467072900
Name:SCHRIDER, THERESA S (LCSW)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:S
Last Name:SCHRIDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 GRAYSON ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94710-2640
Mailing Address - Country:US
Mailing Address - Phone:510-381-0276
Mailing Address - Fax:
Practice Address - Street 1:929 GRAYSON ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-2640
Practice Address - Country:US
Practice Address - Phone:510-381-0276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-24
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA173191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical