Stephen Joseph Clavere, PH.D.

Individual provider Active NPI Counseling Psychologist · Represa, CA

NPI 1801136254 · NPPES record last updated Feb 21, 2013

Key facts

NPI
1801136254
Entity type
Individual (NPI type 1)
Primary specialty
Counseling Psychologist 103TC1900X
License
PSY9022 (CA)
Practice address
300 Prison Rd
Represa, CA 95671-3001
Phone
(916) 985-2561
NPI assigned
Feb 21, 2013
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY9022CAMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Corrections and Rehabilitation-Headquarters Past
since Feb 23, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X PSY9022 CA Yes

Addresses

Primary practice location

300 Prison Rd
Represa, CA 95671-3001

Mailing address

300 Prison Rd
Represa, CA 95671-3001
Phone (916) 985-2561

Other providers in Represa, CA

All providers in Represa, CA · Counseling Psychologist in California

Sources for this page

Verify at the official NPI Registry.