Provider Demographics
NPI:1265698062
Name:SCHAFFER, PRISCILLA DELAIINE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:PRISCILLA
Middle Name:DELAIINE
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:25470 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-4900
Mailing Address - Country:US
Mailing Address - Phone:951-795-5355
Mailing Address - Fax:951-834-9829
Practice Address - Street 1:25470 MEDICAL CENTER DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-4900
Practice Address - Country:US
Practice Address - Phone:951-795-5355
Practice Address - Fax:951-834-9829
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA16951363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR38715Medicare UPIN