Provider Demographics
NPI:1659525186
Name:CLAIR, DIVA P (LMFT33652)
Entity Type:Individual
Prefix:
First Name:DIVA
Middle Name:P
Last Name:CLAIR
Suffix:
Gender:F
Credentials:LMFT33652
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11828 RANCHO BERNARDO RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-1912
Mailing Address - Country:US
Mailing Address - Phone:858-385-9399
Mailing Address - Fax:858-385-9456
Practice Address - Street 1:11828 RANCHO BERNARDO RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-1912
Practice Address - Country:US
Practice Address - Phone:858-385-9399
Practice Address - Fax:858-385-9456
Is Sole Proprietor?:No
Enumeration Date:2008-11-11
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC33652106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist