Provider Demographics
NPI:1720270655
Name:SCHUMACHER, JOHN C
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:C
Last Name:SCHUMACHER
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 1:768 PLEASANT VALLEY ROAD
Mailing Address - Street 2:
Mailing Address - City:DIAMOND SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95619
Mailing Address - Country:US
Mailing Address - Phone:530-621-6659
Mailing Address - Fax:530-653-2179
Practice Address - Street 1:768 PLEASANT VALLEY ROAD
Practice Address - Street 2:
Practice Address - City:DIAMOND SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:95619
Practice Address - Country:US
Practice Address - Phone:530-621-6659
Practice Address - Fax:530-653-2179
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CAIMF 55054106H00000X
CALMFT79070106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor