Provider Demographics
NPI:1902125164
Name:SCHOENSIEGEL, SUE CAROLYN (CAREGIVER)
Entity type:Individual
Prefix:
First Name:SUE
Middle Name:CAROLYN
Last Name:SCHOENSIEGEL
Suffix:
Gender:F
Credentials:CAREGIVER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MIRA ADELANTE
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-3102
Mailing Address - Country:US
Mailing Address - Phone:949-429-2667
Mailing Address - Fax:949-429-2984
Practice Address - Street 1:101 MIRA ADELANTE
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-3102
Practice Address - Country:US
Practice Address - Phone:949-429-2667
Practice Address - Fax:949-429-2984
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver