Provider Demographics
NPI:1104155860
Name:SCHMOLLINGER, JUSTINE M (PHD, JD)
Entity type:Individual
Prefix:DR
First Name:JUSTINE
Middle Name:M
Last Name:SCHMOLLINGER
Suffix:
Gender:F
Credentials:PHD, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:584 CASTRO ST
Mailing Address - Street 2:#614
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-2512
Mailing Address - Country:US
Mailing Address - Phone:415-706-5109
Mailing Address - Fax:
Practice Address - Street 1:31625 HIGHWAY 101 S
Practice Address - Street 2:1080
Practice Address - City:SOLEDAD
Practice Address - State:CA
Practice Address - Zip Code:93960-9529
Practice Address - Country:US
Practice Address - Phone:831-678-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-09
Last Update Date:2011-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist