Provider Demographics
NPI:1497072144
Name:REIDEL, CLARE JOYCE (RN)
Entity Type:Individual
Prefix:MRS
First Name:CLARE
Middle Name:JOYCE
Last Name:REIDEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9702 LENORE DR
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92841-4929
Mailing Address - Country:US
Mailing Address - Phone:714-537-4682
Mailing Address - Fax:
Practice Address - Street 1:18432 GRIDLEY RD
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-5404
Practice Address - Country:US
Practice Address - Phone:562-860-2479
Practice Address - Fax:562-860-7109
Is Sole Proprietor?:No
Enumeration Date:2010-04-20
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA153741163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health