Vivienne Minesa Hendricks-Clark, OTR/L

Primary specialty

Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X

License

4654 Issued in CA

Practice address

701 Larsson St
Manhattan Beach, CA 90266-5943

Phone

(310) 318-2961

NPI assigned

Jul 2, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• NRP Physical Therapy Corp.

  • Physical Therapy Clinic/Center
  • Redondo Beach, CA
  • NPI 1477086643
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1649433301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 LARSSON ST",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902665943",
            "telephone_number": "310-318-2961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 LARSSON ST",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902665943",
            "telephone_number": "310-318-2961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS-CLARK",
        "first_name": "VIVIENNE",
        "middle_name": "MINESA",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "CA",
            "license": "4654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Healthfly Incorporated
• Heart Squad Inc
• Heart Squad, Inc.
• Kimberly Rose Hegg, MFTI
• Courtney Alexandra Helm, AGNP-C
• Martha Jean Hendricks, PH.D.
• Chad Chin Seng Heng, M.D.
• Hengameh Jannati DDS, Inc.
• Tiffany Kathleen Herbert, PH.D.
• Sandra Hernandez

• Neurorehabilitation Occupational Therapist in Manhattan Beach, CA
• Providers in Manhattan Beach, CA by specialty
• Neurorehabilitation Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.