Provider Demographics
NPI:1285904979
Name:SCHNEIDER, RENEE ALEXIS (PHD)
Entity type:Individual
Prefix:DR
First Name:RENEE
Middle Name:ALEXIS
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 BUENA VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-1528
Mailing Address - Country:US
Mailing Address - Phone:706-614-4423
Mailing Address - Fax:
Practice Address - Street 1:1611 BOREL PL STE 211
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-3505
Practice Address - Country:US
Practice Address - Phone:706-614-4423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-11
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23617103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist