Provider Demographics
NPI:1699989848
Name:SCHRADER, DANIELLA (PSYDMFT)
Entity type:Individual
Prefix:DR
First Name:DANIELLA
Middle Name:
Last Name:SCHRADER
Suffix:
Gender:F
Credentials:PSYDMFT
Other - Prefix:
Other - First Name:OREET
Other - Middle Name:DANIELLA
Other - Last Name:SCHRADER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2581 AUTUMN RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-4968
Mailing Address - Country:US
Mailing Address - Phone:818-633-2403
Mailing Address - Fax:
Practice Address - Street 1:2581 AUTUMN RIDGE DR
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91362-4968
Practice Address - Country:US
Practice Address - Phone:818-633-2403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40598106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist