Judith Z Clark is a Clinical in Mammoth Lakes, California. Judith Z Clark practices all healthcare services and medical treatments related to Clinical. The NPI Number for Judith Z Clark is 1356440275. The last update date is 2011-09-20.
Judith Z Clark's current location address is Po 100 Pmb 470, Mammoth Lakes, California. You can contact this provider via phone number 7609248503 and fax number 7609240541. The mailing address for Judith Z Clark is Po 100 Pmb 470, Mammoth Lakes, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Judith Z Clark |
|---|---|
| Address | Po 100 Pmb 470, Mammoth Lakes, California |
| Phone Number | 7609248503 |
| Fax Number | 7609240541 |
| Sole Proprietor | N |
| Credentials | PHD |
NPI Number Detail
| NPI Number | 1356440275 |
|---|---|
| Provider Enumeration Date | 2006-09-21 |
| Last Updated Date | 2011-09-20 |
Provider Mailing Address Detail
| Address | Po 100 Pmb 470 |
|---|---|
| City | Mammoth Lakes |
| State | California (CA) |
| Post Code | 935460100 |
| Phone Number | 7609248503 |
| Fax Number | 7609240541 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | PSY13963 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 11413861 | AETNA | ||
| PSY139630 | CA | -- | |
| CP13963 | CA | MEDICARE PTAN |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Judith Z Clark by the Centers for Medicare & Medicaid Services?
The Judith Z Clark has been assigned the NPI (National Provider Identifier) 1356440275 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete address where Judith Z Clark is physically located?
The Judith Z Clark is situated at the following address: Po 100 Pmb 470, Mammoth Lakes, CA 935460100.
What is Judith Z Clark's area of expertise and its corresponding taxonomy classification?
The Judith Z Clark's field of specialization is Clinical, and it falls under the taxonomy code 103Tc0700X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1356440275 to Judith Z Clark?
The Centers for Medicare & Medicaid Services originally issued the 1356440275 to Judith Z Clark on 2006-09-21.
As of what date was the information pertaining to Judith Z Clark, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Judith Z Clark, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2011-09-20.