Provider Demographics
NPI:1609014968
Name:SCHULMAN, JODI BRIANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:BRIANNE
Last Name:SCHULMAN
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 1:3122 VIA ARCILLA
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-4613
Mailing Address - Country:US
Mailing Address - Phone:949-235-8162
Mailing Address - Fax:
Practice Address - Street 1:4009 PARK BLVD
Practice Address - Street 2:#14
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2619
Practice Address - Country:US
Practice Address - Phone:949-235-8162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-25
Last Update Date:2009-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA243141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical