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General NPI Number Information
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NPI Number | 1902304033
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Entity Type | Individual
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Provider Name | TARA YVONNE ADAMS-CLARKE DPT
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Gender | Female
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Dates
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Enumeration Date | 01/23/2018
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 18300 ROSCOE BLVD
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City | NORTHRIDGE
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State | CA
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Zip | 91325-4105
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Country | US
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Telephone | 818-885-8500
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 5195
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91616
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Country | US
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Telephone | 818-839-0074
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | GE210303
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 294061
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License Number State | CA
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