Provider Demographics
NPI:1205941085
Name:SCHAEFFER, DARLENE BETH (DPT)
Entity type:Individual
Prefix:MISS
First Name:DARLENE
Middle Name:BETH
Last Name:SCHAEFFER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7405 CHARMANT DR
Mailing Address - Street 2:UNIT 2004
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-5010
Mailing Address - Country:US
Mailing Address - Phone:909-260-7739
Mailing Address - Fax:858-810-0174
Practice Address - Street 1:7155 MISSION GORGE RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-1130
Practice Address - Country:US
Practice Address - Phone:619-350-3737
Practice Address - Fax:858-810-0174
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28657225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT28657CMedicare ID - Type Unspecified