MEDICARE: CLARK COMMUNITY DEVELOPMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1225970940
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLARK COMMUNITY DEVELOPMENT

Provider Business Mailing Address
First Line	:	4465 WAWONA ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90065-5133
Country	:	US
Telephone Number	:	323-310-6381
Fax Number	:

Provider Business Practice Location Address
First Line	:	6525 S WESTERN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90047-1812
Country	:	US
Telephone Number	:	323-310-6381
Fax Number	:

Authorized Official
Title or Position	:	CONSULTANT / CLINICAL DIRECTOR
Name	:	MR. ADRIAN TAFOYA
Credential	:	LCSW
Telephone Number	:	310-866-6703

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

Similar Medicare Providers

1619819711 — KAYAM HOME CARE LLC
Practice Location Address:

1920 1/2 N KENMORE AVE
LOS ANGELES, CA
90027-1812

Practice Phone: 303-717-1285
Practice Fax:

1821023037 — DR. JORDAN GELLER M.D.
Practice Location Address:

2080 CENTURY PARK E , SUITE 1812
LOS ANGELES, CA
90067-2001

Practice Phone: 310-277-1812
Practice Fax: 310-300-0189

1447340310 — RICHARD M ABRAMS DDS
Practice Location Address:

3311 GLENDALE BLVD
LOS ANGELES, CA
90039-1812

Practice Phone: 323-665-7665
Practice Fax: 323-953-6695

1417014655 — DR. BRYAN BUMSOO KIM D.M.D.
Practice Location Address:

3030 W 8TH ST , #305
LOS ANGELES, CA
90005-1812

Practice Phone: 213-389-0937
Practice Fax: 213-389-1937

1487785739 — WENDY K HAMMOND LMFT
Practice Location Address:

3315 GLENDALE BLVD , SUITE 4
LOS ANGELES, CA
90039-1812

Practice Phone: 818-486-6306
Practice Fax:

1962533950 — MR. VAHEED SIADAT MFT INTERN
Practice Location Address:

1812 BUTLER AVE APT 4
LOS ANGELES, CA
90025-5476

Practice Phone: 310-914-9245
Practice Fax: 310-914-9245

Directions to “CLARK COMMUNITY DEVELOPMENT ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.