MEDICARE: MRS. CLARA S ADAMS LCSW

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	1041C0700X	Clinical Social Worker	LCS21853	CA

General Provider Information

NPI Number	:	1346364791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CLARA S ADAMS LCSW

Provider Business Mailing Address
First Line	:	3033 MOORPARK AVE
Second Line	:	SUITE 8
City	:	SAN JOSE
State	:	CA
Zip	:	95128-2521
Country	:	US
Telephone Number	:	408-781-2523
Fax Number	:	408-273-6742

Provider Business Practice Location Address
First Line	:	3033 MOORPARK AVE
Second Line	:	SUITE 8
City	:	SAN JOSE
State	:	CA
Zip	:	95128-2521
Country	:	US
Telephone Number	:	408-781-2523
Fax Number	:	408-273-6742

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

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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