Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Latara Tashai Buck

Individual provider Recreation Therapist · NPI 1790414712

Latara Tashai Buck is a Recreation Therapist in Los Angeles, California. Licensed in California. Registered with an NPI since 2022.

Licensed in
CA
In the registry since
2022
Specialties on file
2

Practice location Address checks out

12021 Wilmington Ave Ste 300
Los Angeles, CA 90059-3019
Phone: (424) 454-6020
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 17788 (CA)
Recreation Therapist Taxonomy 225800000X

Record details

NPI number1790414712
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 6, 2022
Last updated in NPPESSeptember 24, 2024
Certification dateSeptember 24, 2024

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