Provider Demographics
NPI:1912237470
Name:SCHROEDER, SARAH (DC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 717
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92085-0717
Mailing Address - Country:US
Mailing Address - Phone:760-414-9700
Mailing Address - Fax:760-414-9707
Practice Address - Street 1:2428 SANTA MONICA BLVD STE 404
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2047
Practice Address - Country:US
Practice Address - Phone:760-414-9700
Practice Address - Fax:760-414-9707
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30221111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor