Provider Demographics
NPI:1861773046
Name:LLAMAS, CLAUDIA CONSUELO
Entity type:Individual
Prefix:MS
First Name:CLAUDIA
Middle Name:CONSUELO
Last Name:LLAMAS
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 1:3517 CAMINO DEL RIO S STE 407
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-4028
Mailing Address - Country:US
Mailing Address - Phone:619-955-8905
Mailing Address - Fax:619-955-8906
Practice Address - Street 1:3517 CAMINO DEL RIO S STE 407
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4028
Practice Address - Country:US
Practice Address - Phone:619-955-8905
Practice Address - Fax:619-955-8906
Is Sole Proprietor?:No
Enumeration Date:2011-09-01
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA962311041C0700X
CAASW60908101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA37FFOtherMEDI-CAL PROVIDER