Basic Information
Provider Information
NPI: 1053742957
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHOO
FirstName: RUBEN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CADTP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3230 WARING CT STE A
Address2:  
City: OCEANSIDE
State: CA
PostalCode: 920564509
CountryCode: US
TelephoneNumber: 7603057528
FaxNumber: 7605094410
Practice Location
Address1: 3230 WARING CT STE A
Address2:  
City: OCEANSIDE
State: CA
PostalCode: 920564509
CountryCode: US
TelephoneNumber: 7603057528
FaxNumber: 7605094410
Other Information
ProviderEnumerationDate: 12/03/2013
LastUpdateDate: 03/19/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X1452CAN Behavioral Health & Social Service ProvidersCounselor 
101YA0400X1452CAY Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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