Provider Demographics
NPI:1912922626
Name:SCHAEPPER, MARY ANN (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ANN
Last Name:SCHAEPPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 BROOKSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4608
Mailing Address - Country:US
Mailing Address - Phone:951-271-0397
Mailing Address - Fax:909-475-6323
Practice Address - Street 1:312 BROOKSIDE AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4608
Practice Address - Country:US
Practice Address - Phone:951-271-0397
Practice Address - Fax:909-475-6323
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA637822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A637820Medicaid
CA00A637820Medicaid
CA00A637820Medicare PIN