Healthcare Provider Details

I. General information

NPI: 1215381231
Provider Name (Legal Business Name): JOSHUA CLARAMUNT M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2016
Last Update Date: 04/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1503 S COAST DR SUITE 202
COSTA MESA CA
92626-1534
US

IV. Provider business mailing address

1503 S COAST DR SUITE 202
COSTA MESA CA
92626-1534
US

V. Phone/Fax

Practice location:
  • Phone: 949-515-5440
  • Fax: 949-515-5444
Mailing address:
  • Phone: 949-515-5440
  • Fax: 949-515-5444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMF88466
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: