Provider Demographics
NPI:1356688352
Name:EDWARDS, CLARE M (PHD)
Entity type:Individual
Prefix:DR
First Name:CLARE
Middle Name:M
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CLARE
Other - Middle Name:M
Other - Last Name:GRUSZKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6780 MISSION GORGE RD
Mailing Address - Street 2:UNIT 13
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-2431
Mailing Address - Country:US
Mailing Address - Phone:575-313-5544
Mailing Address - Fax:
Practice Address - Street 1:2564 STATE ST STE B
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1662
Practice Address - Country:US
Practice Address - Phone:760-334-6262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10251103TC0700X
CAPSY33082103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical