Provider Demographics
NPI:1710284443
Name:SCHWARTZKOPF, VICTORIA CHRISTINE (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:CHRISTINE
Last Name:SCHWARTZKOPF
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:CHRISTINE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12610 W CANTERBURY DR
Mailing Address - Street 2:
Mailing Address - City:EL MIRAGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85335-6319
Mailing Address - Country:US
Mailing Address - Phone:602-989-8929
Mailing Address - Fax:
Practice Address - Street 1:2 W VERNON AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85003-1039
Practice Address - Country:US
Practice Address - Phone:480-398-7324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-15
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-004762225X00000X
225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ606996Medicaid