Provider Demographics
NPI:1962527440
Name:VINES, CLAIRE (PSY D LMFT TF-CBT)
Entity type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:
Last Name:VINES
Suffix:
Gender:F
Credentials:PSY D LMFT TF-CBT
Other - Prefix:MRS
Other - First Name:CLAIRE
Other - Middle Name:M
Other - Last Name:VINES
Other - Suffix:I
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:37 COLGATE DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-3703
Mailing Address - Country:US
Mailing Address - Phone:310-882-1283
Mailing Address - Fax:
Practice Address - Street 1:37 COLGATE DR
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-3703
Practice Address - Country:US
Practice Address - Phone:310-882-1283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49270106H00000X
103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist