Basic Information
| Provider Information | |||||||||
| NPI: | 1285761346 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHAFFER | ||||||||
| FirstName: | SHARI | ||||||||
| MiddleName: | LYNNETTE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3230 GIANT FOREST LOOP | ||||||||
| Address2: | |||||||||
| City: | CHINO HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9099644340 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 233 BASELINE RD | ||||||||
| Address2: | BOX 400 | ||||||||
| City: | LA VERNE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917502353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095932581 | ||||||||
| FaxNumber: | 9098332998 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2007 | ||||||||
| LastUpdateDate: | 07/25/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 48907 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
ID Information
| ID | Type | State | Issuer | Description | 7565A | 01 | CA | OUTPATIENT MENTAL HEALTH | OTHER |