Provider Demographics
NPI:1134692999
Name:BUENROSTRO LARES, CLAUDIA (AMFT, 149184)
Entity type:Individual
Prefix:MISS
First Name:CLAUDIA
Middle Name:
Last Name:BUENROSTRO LARES
Suffix:
Gender:F
Credentials:AMFT, 149184
Other - Prefix:
Other - First Name:CLAUDIA
Other - Middle Name:
Other - Last Name:BUENROSTRO ROBLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9420 OBECK AVE
Mailing Address - Street 2:
Mailing Address - City:ARLETA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-5520
Mailing Address - Country:US
Mailing Address - Phone:818-272-3097
Mailing Address - Fax:
Practice Address - Street 1:11600 ELDRIDGE AVE
Practice Address - Street 2:
Practice Address - City:LAKE VIEW TERRACE
Practice Address - State:CA
Practice Address - Zip Code:91342-6506
Practice Address - Country:US
Practice Address - Phone:888-671-9342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-04
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 106H00000X, 390200000X
149184106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program