Provider Demographics
NPI:1114496882
Name:BRUNSTING, CLAIRE LOUISE
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:LOUISE
Last Name:BRUNSTING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:LOUISE
Other - Last Name:MARSDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22672 LAMBERT ST STE 611
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-1613
Mailing Address - Country:US
Mailing Address - Phone:714-227-2160
Mailing Address - Fax:
Practice Address - Street 1:22672 LAMBERT ST STE 611
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-1613
Practice Address - Country:US
Practice Address - Phone:714-457-7160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-24
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20335235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty