Provider Demographics
NPI:1952048506
Name:SUMMERS, CLAIRE JOY
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:JOY
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3676 VINTON AVE APT 308
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-6084
Mailing Address - Country:US
Mailing Address - Phone:310-801-0406
Mailing Address - Fax:
Practice Address - Street 1:127 BROADWAY STE 205
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-2330
Practice Address - Country:US
Practice Address - Phone:310-801-0406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical