Provider Demographics
NPI:1912613670
Name:SCHREYER, JOETTE GISELE
Entity Type:Individual
Prefix:
First Name:JOETTE
Middle Name:GISELE
Last Name:SCHREYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1719 CARMELITA LN
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:CA
Mailing Address - Zip Code:95329-9791
Mailing Address - Country:US
Mailing Address - Phone:209-454-9808
Mailing Address - Fax:
Practice Address - Street 1:1719 CARMELITA LN
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:CA
Practice Address - Zip Code:95329-9791
Practice Address - Country:US
Practice Address - Phone:209-454-9808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver