Provider Demographics
NPI:1265759740
Name:CLUFF, CHARLES E (MFT)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:E
Last Name:CLUFF
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 IRVING ST # 2
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3265
Mailing Address - Country:US
Mailing Address - Phone:626-710-7418
Mailing Address - Fax:626-282-7791
Practice Address - Street 1:629 IRVING ST # 2
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3265
Practice Address - Country:US
Practice Address - Phone:626-710-7418
Practice Address - Fax:626-282-7791
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC1520106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist