Provider Demographics
NPI:1194862144
Name:LE CLAIRE, ANN BREINHOLT (MFT)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:BREINHOLT
Last Name:LE CLAIRE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:273 OAKVUE RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-3650
Mailing Address - Country:US
Mailing Address - Phone:925-998-5815
Mailing Address - Fax:
Practice Address - Street 1:2723 CROW CANYON RD
Practice Address - Street 2:STE 214
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1583
Practice Address - Country:US
Practice Address - Phone:925-998-5815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40097106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist