Provider Demographics
NPI:1053878686
Name:KING, CLAIRE M
Entity type:Individual
Prefix:MRS
First Name:CLAIRE
Middle Name:M
Last Name:KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 HOPI CT
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4304
Mailing Address - Country:US
Mailing Address - Phone:815-409-1650
Mailing Address - Fax:
Practice Address - Street 1:34 HOPI CT
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4304
Practice Address - Country:US
Practice Address - Phone:815-409-1650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program