Provider Demographics
NPI:1245673177
Name:CAMUA, CLAIRE ITCHON (NP-C)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:ITCHON
Last Name:CAMUA
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:REYES
Other - Last Name:ITCHON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3020 E VISTA CHINO
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-5454
Mailing Address - Country:US
Mailing Address - Phone:760-799-5464
Mailing Address - Fax:
Practice Address - Street 1:555 S SUNRISE WAY STE 217
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-7869
Practice Address - Country:US
Practice Address - Phone:760-799-5464
Practice Address - Fax:855-300-7206
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22831363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily