Provider Demographics
NPI:1023281235
Name:SCHAEFER, LISA (DC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:CRIS
Other - Middle Name:
Other - Last Name:SCHAEFER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 25971
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92799-5971
Mailing Address - Country:US
Mailing Address - Phone:714-556-6656
Mailing Address - Fax:
Practice Address - Street 1:8840 WARNER AVE STE 100
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-3232
Practice Address - Country:US
Practice Address - Phone:714-556-6656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27638111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician