Provider Demographics
NPI:1972094472
Name:CLAUDIO, JEAN ELOISE
Entity Type:Individual
Prefix:
First Name:JEAN ELOISE
Middle Name:
Last Name:CLAUDIO
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 1:858 HUNTINGTON AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6200
Mailing Address - Country:US
Mailing Address - Phone:603-714-2455
Mailing Address - Fax:
Practice Address - Street 1:12777 VALLEY VIEW ST STE 121
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92845-2521
Practice Address - Country:US
Practice Address - Phone:562-682-8045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician