Provider Demographics
NPI:1265566137
Name:SCHAFER, KIMBER LEA (MFT)
Entity type:Individual
Prefix:MRS
First Name:KIMBER
Middle Name:LEA
Last Name:SCHAFER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27618 OPEN CREST DR
Mailing Address - Street 2:
Mailing Address - City:SAUGUS
Mailing Address - State:CA
Mailing Address - Zip Code:91350
Mailing Address - Country:US
Mailing Address - Phone:661-263-8367
Mailing Address - Fax:661-297-7737
Practice Address - Street 1:28065 AVE. STANFORD
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91354
Practice Address - Country:US
Practice Address - Phone:661-313-7129
Practice Address - Fax:661-297-7737
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC43874106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist