Provider Demographics
NPI:1710307624
Name:SCHNEIDER, JILL (DC)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 MASONIC AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-2128
Mailing Address - Country:US
Mailing Address - Phone:510-495-9611
Mailing Address - Fax:
Practice Address - Street 1:904 MASONIC AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-2128
Practice Address - Country:US
Practice Address - Phone:510-495-9611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32179111N00000X, 111NN1001X, 111NP0017X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor
No111NX0800XChiropractic ProvidersChiropractorOrthopedic