Provider Demographics
NPI:1922981646
Name:SCHUTZE, OTTO MAXIMILIAN (RN)
Entity type:Individual
Prefix:
First Name:OTTO
Middle Name:MAXIMILIAN
Last Name:SCHUTZE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 CEDAR POINTE LOOP APT 508
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4149
Mailing Address - Country:US
Mailing Address - Phone:216-544-4034
Mailing Address - Fax:
Practice Address - Street 1:140 CEDAR POINTE LOOP APT 508
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4149
Practice Address - Country:US
Practice Address - Phone:216-544-4034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA786948163W00000X, 163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
118300257OtherCERTIFIED HOSPICE & PALLIATIVE NURSE (CHPN)