Provider Demographics
NPI:1487090791
Name:SCHUSTER, ADINA NICOLE
Entity type:Individual
Prefix:MISS
First Name:ADINA
Middle Name:NICOLE
Last Name:SCHUSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5616 FOXWOOD DR APT E
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91377-3964
Mailing Address - Country:US
Mailing Address - Phone:818-359-0894
Mailing Address - Fax:
Practice Address - Street 1:5616 FOXWOOD DR APT E
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:CA
Practice Address - Zip Code:91377-3964
Practice Address - Country:US
Practice Address - Phone:818-359-0894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X, 390200000X, 1041C0700X
CA887021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program