Provider Demographics
NPI:1487363750
Name:SPIVAK, CLAIRE DANIELLE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:DANIELLE
Last Name:SPIVAK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25171 LA JOLLA WAY UNIT G
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-8015
Mailing Address - Country:US
Mailing Address - Phone:650-766-1390
Mailing Address - Fax:
Practice Address - Street 1:23011 MOULTON PKWY STE E5
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1225
Practice Address - Country:US
Practice Address - Phone:714-202-7366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist