Provider Demographics
NPI:1396617791
Name:CLUFF, MABEL (LE)
Entity type:Individual
Prefix:
First Name:MABEL
Middle Name:
Last Name:CLUFF
Suffix:
Gender:F
Credentials:LE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 TELEGRAPH AVE # 9
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-1984
Mailing Address - Country:US
Mailing Address - Phone:510-812-7084
Mailing Address - Fax:341-946-6182
Practice Address - Street 1:3101 TELEGRAPH AVE # 9
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1984
Practice Address - Country:US
Practice Address - Phone:510-812-7084
Practice Address - Fax:341-946-6182
Is Sole Proprietor?:No
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL10068174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist