Provider Demographics
NPI:1528294386
Name:SCHROEDER, LENKA (MFT)
Entity type:Individual
Prefix:
First Name:LENKA
Middle Name:
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 KUCK LN
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-9606
Mailing Address - Country:US
Mailing Address - Phone:707-795-6954
Mailing Address - Fax:707-769-8469
Practice Address - Street 1:365 KUCK LN
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-9606
Practice Address - Country:US
Practice Address - Phone:707-795-6954
Practice Address - Fax:707-769-8469
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50749106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist