Healthcare Provider Details

I. General information

NPI: 1801766472
Provider Name (Legal Business Name): CLARA EVA SIMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10309 SANTA MONICA BLVD
LOS ANGELES CA
90025-5007
US

IV. Provider business mailing address

18615 PRAIRIE ST
NORTHRIDGE CA
91324-3134
US

V. Phone/Fax

Practice location:
  • Phone: 310-553-5984
  • Fax:
Mailing address:
  • Phone: 707-241-5249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: