Basic Information
Provider Information
NPI: 1538623434
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHACHER
FirstName: ELEANOR
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: CADCII
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8898 CLAIREMONT MESA BLVD STE H
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921231127
CountryCode: US
TelephoneNumber: 8587151211
FaxNumber: 8587151274
Practice Location
Address1: 490 N GRAPE ST
Address2:  
City: ESCONDIDO
State: CA
PostalCode: 920253079
CountryCode: US
TelephoneNumber: 7609759939
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/24/2019
LastUpdateDate: 01/04/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/04/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400XA014240315CAN Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
101YM0800X  N Behavioral Health & Social Service ProvidersCounselorMental Health
101YM0800X12393CAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


Home