Healthcare Provider Details

I. General information

NPI: 1306771746
Provider Name (Legal Business Name): CLAIRE COURON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2060 OTAY LAKES RD STE 270
CHULA VISTA CA
91913-1364
US

IV. Provider business mailing address

7832 LAURELRIDGE RD
SAN DIEGO CA
92120-2213
US

V. Phone/Fax

Practice location:
  • Phone: 619-546-0039
  • Fax:
Mailing address:
  • Phone: 619-723-2522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: