Provider Demographics
NPI:1174100473
Name:DAVENPORT, CLAUDIA LORRAINE (MAPT)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:LORRAINE
Last Name:DAVENPORT
Suffix:
Gender:F
Credentials:MAPT
Other - Prefix:
Other - First Name:CLAUDIA
Other - Middle Name:LORRAINE
Other - Last Name:FANSLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MAPT
Mailing Address - Street 1:953 CANYON RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93463-8705
Mailing Address - Country:US
Mailing Address - Phone:805-216-9477
Mailing Address - Fax:
Practice Address - Street 1:2028 VILLAGE LN STE 206
Practice Address - Street 2:
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-3223
Practice Address - Country:US
Practice Address - Phone:805-680-1246
Practice Address - Fax:805-617-3920
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT12283225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist