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NPI Code Detail

MEDICARE: CLARE MATRIX

MEDICARE: CLARE MATRIX
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
1324500000XSubstance Abuse Rehabilitation Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1190016BNOTHERCASTATE LICENSE
2190016PNOTHERCADHCS-AOD STATE LICENSE

General Provider Information

NPI Number : 1043537913
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLARE MATRIX
Provider Business Mailing Address
First Line : 909 PICO BLVD
Second Line :
City : SANTA MONICA
State : CA
Zip : 90405-1326
Country : US
Telephone Number : 310-314-6200
Fax Number : 310-450-2024
Provider Business Practice Location Address
First Line : 907-909 PICO BLVD.
Second Line :
City : SANTA MONICA
State : CA
Zip : 90405-1326
Country : US
Telephone Number : 310-314-6200
Fax Number : 310-450-2024
Authorized Official
Title or Position : EXECUTIVE OFFICER
Name : MATT WALTON
Credential :
Telephone Number : 310-314-6200
Provider Enumeration Date : 04/30/2010
Last Update Date : 09/20/2024

Similar Medicare Providers

1225832157 — CHRISTINA BLUM
Practice Location Address:
909 PICO BLVD
SANTA MONICA, CA
90405-1326
Practice Phone: 866-452-5273
Practice Fax:
1639299407 — DR. KATHERYN LEANNE WHITTAKER PSYD, LMFT, LPCC
Practice Location Address:
909 PICO BLVD
SANTA MONICA, CA
90405-1326
Practice Phone: 714-931-9331
Practice Fax:
1063632230 — DARLENE GUTIERREZ
Practice Location Address:
909 PICO BLVD
SANTA MONICA, CA
90405-1326
Practice Phone: 310-314-6200
Practice Fax:
1699979021 — AFUMI SAITO MFT
Practice Location Address:
909 PICO BLVD
SANTA MONICA, CA
90405-1326
Practice Phone: 866-452-5273
Practice Fax:
1285910232 — MS. LEAH DYSON
Practice Location Address:
909 PICO BLVD
SANTA MONICA, CA
90405-1326
Practice Phone: 310-314-6200
Practice Fax: 310-396-6974
1043596612 — DEBRA LEE POORMAN
Practice Location Address:
909 PICO BLVD
SANTA MONICA, CA
90405-1326
Practice Phone: 310-614-6200
Practice Fax: 310-450-2024

Directions to “CLARE MATRIX ” Practice Location

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