Provider Demographics
NPI:1972768497
Name:VAN SCHOICK, MATT EDWARD
Entity Type:Individual
Prefix:MR
First Name:MATT
Middle Name:EDWARD
Last Name:VAN SCHOICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24481 ROSALES CIR
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-4825
Mailing Address - Country:US
Mailing Address - Phone:949-310-2761
Mailing Address - Fax:
Practice Address - Street 1:24481 ROSALES CIR
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-4825
Practice Address - Country:US
Practice Address - Phone:949-310-2761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health