Provider Demographics
NPI:1144845892
Name:HERM, CLAIRE (PT, DPT)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:HERM
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:
Other - Last Name:HORAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:629 SUMNER WAY
Mailing Address - Street 2:UNIT 2
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-0654
Mailing Address - Country:US
Mailing Address - Phone:918-853-2662
Mailing Address - Fax:760-826-2525
Practice Address - Street 1:15088 JARRELL PL
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-5733
Practice Address - Country:US
Practice Address - Phone:918-853-2662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA302153225100000X
VA2305213639225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist