Provider Demographics
NPI:1578746517
Name:SCHUTZ, ROBERTA M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ROBERTA
Middle Name:M
Last Name:SCHUTZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:BOBBI
Other - Middle Name:M
Other - Last Name:SCHUTZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:150 VALPREDA RD
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-2973
Mailing Address - Country:US
Mailing Address - Phone:760-736-6767
Mailing Address - Fax:760-736-8740
Practice Address - Street 1:217 EARLHAM ST
Practice Address - Street 2:
Practice Address - City:RAMONA
Practice Address - State:CA
Practice Address - Zip Code:92065-1589
Practice Address - Country:US
Practice Address - Phone:760-566-1779
Practice Address - Fax:760-789-5946
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT134773-35011041C0700X
CA280431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical