Provider Demographics
NPI:1770503575
Name:MATNEY, CLARE M (MD)
Entity Type:Individual
Prefix:DR
First Name:CLARE
Middle Name:M
Last Name:MATNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CLARE
Other - Middle Name:M
Other - Last Name:SHERIDAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12402 INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE B-6
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-5871
Mailing Address - Country:US
Mailing Address - Phone:760-780-1237
Mailing Address - Fax:877-780-3252
Practice Address - Street 1:12402 INDUSTRIAL BLVD
Practice Address - Street 2:SUITE B-6
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-5871
Practice Address - Country:US
Practice Address - Phone:760-780-1237
Practice Address - Fax:877-780-3252
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2019-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42818207QA0401X, 207RA0401X, 2080C0008X, 2083A0300X, 2084A0401X, 2084P0802X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No2080C0008XAllopathic & Osteopathic PhysiciansPediatricsChild Abuse Pediatrics
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A428180Medicaid
CA00A428180Medicaid
A29638Medicare UPIN