Individual provider Active NPI

Claire Craddick

  • Marriage & Family Therapist
  • Rancho Cucamonga, CA
National Provider Identifier
1124717202
Registry record updated Oct 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
149648 Issued in CA
Practice address
9135 Archibald Ave Ste B
Rancho Cucamonga, CA 91730-5227
Phone
(424) 272-1806
NPI assigned
May 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 120675 CA
Marriage & Family Therapist 106H00000X 149648 CA Primary

Addresses

Primary practice location

9135 Archibald Ave Ste B
Rancho Cucamonga, CA 91730-5227

Mailing address

5500 University Pkwy
San Bernardino, CA 92407-2318
Phone (909) 537-5040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
120675CAMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728086400000",
    "number": "1124717202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 UNIVERSITY PKWY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924072318",
            "telephone_number": "909-537-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9135 ARCHIBALD AVE STE B",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305227",
            "telephone_number": "424-272-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRADDICK",
        "first_name": "CLAIRE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-03",
        "last_updated": "2024-10-05",
        "certification_date": "2024-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "120675",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "149648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.