Provider Demographics
NPI:1922522069
Name:SCHULTZ, EMILY JEAN (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:JEAN
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1261 VIA LUCERO
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-4263
Mailing Address - Country:US
Mailing Address - Phone:617-257-0081
Mailing Address - Fax:
Practice Address - Street 1:1261 VIA LUCERO
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4263
Practice Address - Country:US
Practice Address - Phone:617-257-0081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-31
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1779-MH-MF106H00000X
CA120396106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist