Provider Demographics
NPI:1285773507
Name:CAPOR, CLAIRE (MSW)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:CAPOR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2714 TELEGRAPH AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-1117
Mailing Address - Country:US
Mailing Address - Phone:510-649-1273
Mailing Address - Fax:510-339-2751
Practice Address - Street 1:2714 TELEGRAPH AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1117
Practice Address - Country:US
Practice Address - Phone:510-649-1273
Practice Address - Fax:510-339-2751
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 38931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ26488ZMedicare ID - Type UnspecifiedMEDICARE