MEDICARE: CLARKESONS ENTERPRISES INC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1588968804
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLARKESONS ENTERPRISES INC

Provider Business Mailing Address
First Line	:	4990 SPEAK LN
Second Line	:	SUITE 260
City	:	SAN JOSE
State	:	CA
Zip	:	95118-4004
Country	:	US
Telephone Number	:	408-977-1133
Fax Number	:	408-445-1299

Provider Business Practice Location Address
First Line	:	4990 SPEAK LN
Second Line	:	SUITE 260
City	:	SAN JOSE
State	:	CA
Zip	:	95118-4004
Country	:	US
Telephone Number	:	408-977-1133
Fax Number	:	408-445-1299

Authorized Official
Title or Position	:	DIRECTOR/OWNER
Name	:	MR. RICHARD OSBORNE CLARKE
Credential	:
Telephone Number	:	408-977-1133

Provider Enumeration Date	:	12/29/2010
Last Update Date	:	12/29/2010

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