Basic Information
Provider Information
NPI: 1134248800
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CLAGGETT
FirstName: MARY
MiddleName: CHRISTINA
NamePrefix: MS.
NameSuffix:  
Credential: AMFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1000
Address2:  
City: BAKERSFIELD
State: CA
PostalCode: 933021000
CountryCode: US
TelephoneNumber: 6618686601
FaxNumber: 6618686666
Practice Location
Address1: 2621 OSWELL ST
Address2: STE. 119
City: BAKERSFIELD
State: CA
PostalCode: 933063172
CountryCode: US
TelephoneNumber: 6618686750
FaxNumber: 6618686752
Other Information
ProviderEnumerationDate: 03/27/2007
LastUpdateDate: 02/09/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000X  Y Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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