Provider Demographics
NPI:1912001462
Name:SCHNEIDER, JAY MARTIN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAY
Middle Name:MARTIN
Last Name:SCHNEIDER
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 1:2727 CAMINO DEL RIO S STE 311
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3741
Mailing Address - Country:US
Mailing Address - Phone:858-538-5587
Mailing Address - Fax:619-692-3242
Practice Address - Street 1:2727 CAMINO DEL RIO S STE 311
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3741
Practice Address - Country:US
Practice Address - Phone:858-538-5587
Practice Address - Fax:619-692-3242
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS95731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical