Provider Demographics
NPI:1841438843
Name:WHITLOCK, CLAIRE ELIZABETH (PT)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:ELIZABETH
Last Name:WHITLOCK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2667 N MOORPARK RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-3001
Mailing Address - Country:US
Mailing Address - Phone:805-492-0429
Mailing Address - Fax:805-492-0308
Practice Address - Street 1:2667 N MOORPARK RD
Practice Address - Street 2:SUITE 108
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-3001
Practice Address - Country:US
Practice Address - Phone:805-492-0429
Practice Address - Fax:805-492-0308
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-28
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT351562251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT35156OtherSTATE OF CA LICENSE #