Provider Demographics
NPI:1497743918
Name:SCHAEFFER, JOHN LESTER (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LESTER
Last Name:SCHAEFFER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 CALIFORNIA ST STE 2710
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-5818
Mailing Address - Country:US
Mailing Address - Phone:916-320-4222
Mailing Address - Fax:888-370-2829
Practice Address - Street 1:101 CALIFORNIA ST STE 2710
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-5818
Practice Address - Country:US
Practice Address - Phone:916-320-4222
Practice Address - Fax:888-370-2829
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-10
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A95362084P0805X, 2084P0800X, 2084P0804X
CO387502084P0805X, 2084P0800X, 2084P0804X
NMA-1243-032084P0800X, 2084P0804X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFK534ZMedicaid