Provider Demographics
NPI:1790321214
Name:SCHULTE, JESSE (PHD)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:SCHULTE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2672 BAYSHORE PKWY STE 1044
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-1015
Mailing Address - Country:US
Mailing Address - Phone:650-862-7320
Mailing Address - Fax:408-905-4918
Practice Address - Street 1:2672 BAYSHORE PKWY STE 1044
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-1015
Practice Address - Country:US
Practice Address - Phone:650-862-7320
Practice Address - Fax:408-905-4918
Is Sole Proprietor?:No
Enumeration Date:2019-11-19
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34520103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical