Provider Demographics
NPI:1942265905
Name:SOULCHECK, TARYN GOFF (MPT)
Entity Type:Individual
Prefix:MRS
First Name:TARYN
Middle Name:GOFF
Last Name:SOULCHECK
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MISS
Other - First Name:TARYN
Other - Middle Name:JOANNE
Other - Last Name:GOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:1127 CALLE CASTANO
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4646
Mailing Address - Country:US
Mailing Address - Phone:818-756-2563
Mailing Address - Fax:818-904-0970
Practice Address - Street 1:14600 SHERMAN WAY
Practice Address - Street 2:SUITE #300
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2283
Practice Address - Country:US
Practice Address - Phone:818-756-2563
Practice Address - Fax:818-904-0970
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT27948225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist