Provider Demographics
NPI:1831418664
Name:ANDERSEN, CLAIRE ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:ELIZABETH
Last Name:ANDERSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CZLAIRE
Other - Middle Name:
Other - Last Name:ANDERSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:13010 POWAY ROAD
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-4520
Mailing Address - Country:US
Mailing Address - Phone:858-218-3000
Mailing Address - Fax:858-633-4688
Practice Address - Street 1:13010 POWAY ROAD
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-4520
Practice Address - Country:US
Practice Address - Phone:858-218-3000
Practice Address - Fax:858-633-4688
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9610282-12052084P0800X, 2084P0804X
WAML 601654992084P0800X
CAA1259422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry