Provider Demographics
NPI:1811316946
Name:SCHINDEL, JARED (HLAD)
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:SCHINDEL
Suffix:
Gender:M
Credentials:HLAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 S SULLIVAN ST SPC 46
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-1644
Mailing Address - Country:US
Mailing Address - Phone:714-292-0783
Mailing Address - Fax:
Practice Address - Street 1:24352 ROCKFIELD BLVD
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-4742
Practice Address - Country:US
Practice Address - Phone:949-461-0166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-16
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50297225700000X
CA8711237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA50297OtherCERTIFIED MASSAGE THERAPIST