Provider Demographics
NPI:1750126553
Name:CEMAN, CLARE
Entity type:Individual
Prefix:
First Name:CLARE
Middle Name:
Last Name:CEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 S BROADWAY AVE APT 838
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-7708
Mailing Address - Country:US
Mailing Address - Phone:945-400-7942
Mailing Address - Fax:
Practice Address - Street 1:115 E HICKORY AVE STE E
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-7274
Practice Address - Country:US
Practice Address - Phone:469-269-2101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA138033106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist