Provider Demographics
NPI:1891842597
Name:ERROL D. SCHUBOT, PH.D., A PSYCHOLOGICAL CORPORATION
Entity Type:Organization
Organization Name:ERROL D. SCHUBOT, PH.D., A PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERROL
Authorized Official - Middle Name:D
Authorized Official - Last Name:SCHUBOT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:408-241-0198
Mailing Address - Street 1:1745 SARATOGA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-5201
Mailing Address - Country:US
Mailing Address - Phone:408-241-0198
Mailing Address - Fax:
Practice Address - Street 1:1745 SARATOGA AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129
Practice Address - Country:US
Practice Address - Phone:408-241-0198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 003164103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOPL31640Medicare PIN