Provider Demographics
NPI:1437455813
Name:ALLEN-BUTLER, CLAUDETTE (LAADC)
Entity Type:Individual
Prefix:MRS
First Name:CLAUDETTE
Middle Name:
Last Name:ALLEN-BUTLER
Suffix:
Gender:F
Credentials:LAADC
Other - Prefix:MS
Other - First Name:CLAUDETTE
Other - Middle Name:
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8910 CLAIREMONT MESA BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1104
Mailing Address - Country:US
Mailing Address - Phone:858-518-2192
Mailing Address - Fax:
Practice Address - Street 1:220 EUCLID AVE STE 40
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92114-3617
Practice Address - Country:US
Practice Address - Phone:858-518-2192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-02
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC3450409101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)