Provider Demographics
NPI:1881817153
Name:MARK SCHINDLER, PH.D.
Entity Type:Organization
Organization Name:MARK SCHINDLER, PH.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHINDLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-454-5588
Mailing Address - Street 1:5256 LA JOLLA BLVD
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-8109
Mailing Address - Country:US
Mailing Address - Phone:858-454-5588
Mailing Address - Fax:858-454-5588
Practice Address - Street 1:5256 LA JOLLA BLVD
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-8109
Practice Address - Country:US
Practice Address - Phone:858-454-5588
Practice Address - Fax:858-454-5588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY7815103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP7815BMedicare ID - Type Unspecified