Provider Demographics
NPI:1356554984
Name:CLARK, FLORENCE ARCURI (PHD, OTR L)
Entity type:Individual
Prefix:DR
First Name:FLORENCE
Middle Name:ARCURI
Last Name:CLARK
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Gender:F
Credentials:PHD, OTR L
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Mailing Address - Street 1:635 W 35TH ST
Mailing Address - Street 2:# 2180
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90089-0001
Mailing Address - Country:US
Mailing Address - Phone:323-442-3340
Mailing Address - Fax:323-442-3351
Practice Address - Street 1:2250 ALCAZAR ST
Practice Address - Street 2:CHP-133
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-9003
Practice Address - Country:US
Practice Address - Phone:323-442-3340
Practice Address - Fax:323-442-3351
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA4175225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4175OtherLICENSE NUMBER