Provider Demographics
NPI:1740966563
Name:SCHNABEL, MEGAN CATHERINE
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:CATHERINE
Last Name:SCHNABEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAKE
Other - Middle Name:CATHERINE
Other - Last Name:SCHNABEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6203 SAN IGNACIO AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1371
Mailing Address - Country:US
Mailing Address - Phone:669-220-1905
Mailing Address - Fax:
Practice Address - Street 1:6203 SAN IGNACIO AVE STE 150
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1371
Practice Address - Country:US
Practice Address - Phone:669-220-1905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X, 390200000X, 172V00000X
CAAMFT149851106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist