Provider Demographics
NPI:1982074159
Name:SCHAPER, TRACEY (NP)
Entity Type:Individual
Prefix:MS
First Name:TRACEY
Middle Name:
Last Name:SCHAPER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 MISSION GROVE PKWY N
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-6246
Mailing Address - Country:US
Mailing Address - Phone:949-933-8133
Mailing Address - Fax:
Practice Address - Street 1:297 MISSION GROVE PKWY N
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-6246
Practice Address - Country:US
Practice Address - Phone:949-933-8133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001561364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health