Provider Demographics
NPI:1619442449
Name:SCHAAF, BRITTANY VANDER
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:VANDER
Last Name:SCHAAF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3867 COTTONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94506-6007
Mailing Address - Country:US
Mailing Address - Phone:442-628-8466
Mailing Address - Fax:844-262-8466
Practice Address - Street 1:4 CROW CANYON CT STE 150
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1679
Practice Address - Country:US
Practice Address - Phone:844-262-8466
Practice Address - Fax:844-262-8466
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18-8785106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA18-8785-118089OtherBEHAVIOR TECHNICIAN