Provider Demographics
NPI:1356373971
Name:CONARD, HELEN LINDA (PHD)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:LINDA
Last Name:CONARD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:HELEN
Other - Middle Name:LINDA
Other - Last Name:CONARD DESMARAIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:427 YALE AVE
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-4340
Mailing Address - Country:US
Mailing Address - Phone:909-985-9938
Mailing Address - Fax:909-626-1413
Practice Address - Street 1:427 YALE AVE
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4340
Practice Address - Country:US
Practice Address - Phone:909-985-9938
Practice Address - Fax:909-626-1413
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9481103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFJ841AMedicare PIN