Provider Demographics
NPI:1699910075
Name:CLARET, ELIZABETH
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:CLARET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LIZ
Other - Middle Name:
Other - Last Name:CLARET
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3725 WESTWIND BLVD
Mailing Address - Street 2:STE. 101
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-1099
Mailing Address - Country:US
Mailing Address - Phone:707-565-5912
Mailing Address - Fax:
Practice Address - Street 1:3725 WESTWIND BLVD
Practice Address - Street 2:STE. 101
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-1099
Practice Address - Country:US
Practice Address - Phone:707-565-5912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS142501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical