Provider Demographics
NPI:1578579702
Name:AUSTIN, CLAIRE A (PA)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:A
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 SHAW AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-4096
Mailing Address - Country:US
Mailing Address - Phone:559-324-7001
Mailing Address - Fax:559-324-7033
Practice Address - Street 1:1555 SHAW AVE STE 101
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-4096
Practice Address - Country:US
Practice Address - Phone:559-324-7001
Practice Address - Fax:559-324-7033
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA53420363AM0700X, 363A00000X
DEC5-0001324363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA142241Medicare PIN
PA071527Medicare PIN