Healthcare Provider Details

I. General information

NPI: 1104731942
Provider Name (Legal Business Name): CLAUDIA HAVENS DIMOND APCC, AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3233 E BROADWAY STE 2
LONG BEACH CA
90803-5817
US

IV. Provider business mailing address

3233 E BROADWAY STE 2
LONG BEACH CA
90803-5817
US

V. Phone/Fax

Practice location:
  • Phone: 575-779-1747
  • Fax:
Mailing address:
  • Phone: 206-817-0023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number20197
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number157165
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: