Provider Demographics
NPI:1508880139
Name:SELAME, CLAUDIO A (PHD)
Entity Type:Individual
Prefix:DR
First Name:CLAUDIO
Middle Name:A
Last Name:SELAME
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3 EDGAR CT
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-4330
Mailing Address - Country:US
Mailing Address - Phone:805-630-5566
Mailing Address - Fax:805-926-8314
Practice Address - Street 1:2800 CAMINO DOS RIOS
Practice Address - Street 2:SUITE 101A
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-1138
Practice Address - Country:US
Practice Address - Phone:805-630-5566
Practice Address - Fax:805-926-8314
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12438103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
R95931Medicare UPIN
CABF030ZMedicare UPIN