Provider Demographics
NPI:1922155530
Name:HOWARD, CLAIR L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CLAIR
Middle Name:L
Last Name:HOWARD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2926 LONE TREE WAY
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-4924
Mailing Address - Country:US
Mailing Address - Phone:925-522-0465
Mailing Address - Fax:925-513-0073
Practice Address - Street 1:2926 LONE TREE WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-4924
Practice Address - Country:US
Practice Address - Phone:925-522-0465
Practice Address - Fax:925-513-0073
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 16263103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PL16263OMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER