Individual
CLAUDIA V WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2120 ALPINE BLVD, ALPINE, CA 91901-2113
(619) 445-2644
Mailing address
2120 ALPINE BLVD, ALPINE, CA 91901-2113
(619) 445-2644
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MHRS171M00000X
ALPINE SPECIAL TREATMENT CENTER
CA
Enumeration date
03/17/2022
Last updated
04/01/2024
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