Provider Demographics
NPI:1528125895
Name:MARTIN, CLAIRE ELIZABETH (LCSW)
Entity type:Individual
Prefix:MS
First Name:CLAIRE
Middle Name:ELIZABETH
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 HOSP WAY APT 201
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1221
Mailing Address - Country:US
Mailing Address - Phone:760-419-8975
Mailing Address - Fax:
Practice Address - Street 1:240 S HICKORY ST STE 110
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4356
Practice Address - Country:US
Practice Address - Phone:760-747-0205
Practice Address - Fax:760-747-0805
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 222881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7484OtherMEDICAL PRIVIDER NUMBER