MEDICARE: TARA PEARCE OTR/L

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	225XH1200X	Hand Occupational Therapist	12859	CA

General Provider Information

NPI Number	:	1306299524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA PEARCE OTR/L

Provider Business Mailing Address
First Line	:	2370 MARKET ST # 220
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94114-1521
Country	:	US
Telephone Number	:	903-450-3346
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 HAUSER BLVD APT 5L
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-5499
Country	:	US
Telephone Number	:	903-450-3346
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2016
Last Update Date	:	03/03/2017

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Directions to “ TARA PEARCE OTR/L” Practice Location

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