Provider Demographics
NPI:1255535035
Name:SCHROFFEL, ALAN (PHD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:SCHROFFEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:ALAN
Other - Middle Name:
Other - Last Name:SCHROFFEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:403 CHINN ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-4338
Mailing Address - Country:US
Mailing Address - Phone:707-578-8765
Mailing Address - Fax:707-578-8765
Practice Address - Street 1:403 CHINN ST
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-4338
Practice Address - Country:US
Practice Address - Phone:707-578-8765
Practice Address - Fax:707-578-8765
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS88291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical