Provider Demographics
NPI:1578804753
Name:SCHULTZ, DONALD (PHD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 WILSHIRE BLVD STE 310
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-2335
Mailing Address - Country:US
Mailing Address - Phone:310-592-3405
Mailing Address - Fax:
Practice Address - Street 1:3201 WILSHIRE BLVD STE 310
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-2335
Practice Address - Country:US
Practice Address - Phone:310-592-3405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-12
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19721103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical