Provider Demographics
NPI:1407180516
Name:GIRCZYC, CLAIRE WILKINSON (LMFT)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:WILKINSON
Last Name:GIRCZYC
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 S GORDON WAY
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-3732
Mailing Address - Country:US
Mailing Address - Phone:650-906-8312
Mailing Address - Fax:
Practice Address - Street 1:1059 EL MONTE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4601
Practice Address - Country:US
Practice Address - Phone:650-906-8312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-22
Last Update Date:2010-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 37042106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist