Healthcare Provider Details

I. General information

NPI: 1164336582
Provider Name (Legal Business Name): CLARE ELENA REDLICK-PERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CLARE ELENA REDLICK

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 N EL MOLINO AVE
PASADENA CA
91101-1805
US

IV. Provider business mailing address

1542 E BROADWAY APT 1
GLENDALE CA
91205-1526
US

V. Phone/Fax

Practice location:
  • Phone: 626-792-2770
  • Fax:
Mailing address:
  • Phone: 707-331-5534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: