Healthcare Provider Details

I. General information

NPI: 1215640503
Provider Name (Legal Business Name): CLAIRE YEAGER LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2023
Last Update Date: 01/02/2023
Certification Date: 01/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27803 S MONTEREINA DR
RANCHO PALOS VERDES CA
90275-1230
US

IV. Provider business mailing address

1024 BAYSIDE DR 101 UNIT 101
NEWPORT BEACH CA
92660-7462
US

V. Phone/Fax

Practice location:
  • Phone: 949-872-8180
  • Fax:
Mailing address:
  • Phone: 949-872-8180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT134738
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: