Provider Demographics
NPI:1760516868
Name:SCHAEFER, STEPHEN E (LCSW)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:E
Last Name:SCHAEFER
Suffix:
Gender:M
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:PO BOX 86020
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92138-6020
Mailing Address - Country:US
Mailing Address - Phone:858-452-3915
Mailing Address - Fax:858-452-1798
Practice Address - Street 1:3013 WOODFORD DR
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-3549
Practice Address - Country:US
Practice Address - Phone:858-452-3915
Practice Address - Fax:858-452-1798
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 105511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical