Provider Demographics
NPI:1306306048
Name:SCHULTZ, DINA L (NP)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:L
Last Name:SCHULTZ
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 1:23340 ZUNIGA RD
Mailing Address - Street 2:
Mailing Address - City:TOPANGA
Mailing Address - State:CA
Mailing Address - Zip Code:90290-3958
Mailing Address - Country:US
Mailing Address - Phone:310-702-6367
Mailing Address - Fax:
Practice Address - Street 1:23340 ZUNIGA RD
Practice Address - Street 2:
Practice Address - City:TOPANGA
Practice Address - State:CA
Practice Address - Zip Code:90290-3958
Practice Address - Country:US
Practice Address - Phone:310-702-6367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95011298363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA788793OtherRN LICENSE
CA95011298OtherNURSE PRACTITIONER LICENSE
CA95011298OtherNURSE PRACTITIONER FURNISHING