Kina Annette Johnson Clark in Roseville - Clinical
Kina Annette Johnson Clark - NPI 1326061813
Kina Annette Johnson Clark is a Clinical in Roseville, California. Kina Annette Johnson Clark practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kina Annette Johnson Clark is 1326061813. The last update date is 2023-03-23.
Kina Annette Johnson Clark's current location address is 1380 Lead Hill Blvd, Roseville, California. You can contact this provider via phone number 9167264030 and fax number 9167863080. The mailing address for Kina Annette Johnson Clark is 1380 Lead Hill Blvd, Roseville, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kina Annette Johnson Clark |
|---|---|
| Address | 1380 Lead Hill Blvd, Roseville, California |
| Phone Number | 9167264030 |
| Fax Number | 9167863080 |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1326061813 |
|---|---|
| Provider Enumeration Date | 2006-07-25 |
| Last Updated Date | 2023-03-23 |
Provider Mailing Address Detail
| Address | 1380 Lead Hill Blvd |
|---|---|
| City | Roseville |
| State | California (CA) |
| Post Code | 956612941 |
| Phone Number | 9167264030 |
| Fax Number | 9167863080 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | PSY16066 |
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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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What is the unique 10-digit identifier code issued to Kina Annette Johnson Clark by the Centers for Medicare & Medicaid Services?
The Kina Annette Johnson Clark has been assigned the NPI (National Provider Identifier) 1326061813 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you share the physical location details of Kina Annette Johnson Clark?
The Kina Annette Johnson Clark is situated at 1380 Lead Hill Blvd, in the city of Roseville, state of CA, with the zip code 956612941.
What is the Kina Annette Johnson Clark's specialty and taxonomy code?
The Kina Annette Johnson Clark's specialty is Clinical, and the corresponding taxonomy code is 103Tc0700X.
On what date did the Kina Annette Johnson Clark receive its 1326061813 assignment from the Centers for Medicare & Medicaid Services?
The Kina Annette Johnson Clark was assigned its 1326061813 by the Centers for Medicare & Medicaid Services on 2006-07-25.
When was the Kina Annette Johnson Clark's information last updated?
The Kina Annette Johnson Clark's information was last updated on 2023-03-23.