JEFFREY PAUL CLARK


Address: 1932 Viking Dr Nw, Rochester, MN 55901-2460
Phone: 1800422016

JEFFREY PAUL CLARK (NPI# 1003979600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1003979600
Entity Type Individual
Full Name JEFFREY PAUL CLARK
Credential M.A.
Practice Address 1932 Viking Dr Nw
Rochester
MN 55901-2460
Mailing Address 1926 26th Ave Nw
Rochester
MN 55901-8064
Practice Telephone 1800422016
Mailing Telephone 5072612777
Enumeration Date 2006-12-18
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC0700X Psychologist
Specialization: Clinical
LP3310 MN Behavioral Health & Social Service Providers

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1891989158 Jeffrey Michael Clark Dentist 10429 Lagrima De Oro Rd Ne, Albuquerque, NM 87111 2007-08-30

Office Location

Street Address 1932 VIKING DR NW
City ROCHESTER
State MN
Zip Code 55901-2460

Providers in the same location

NPI Name Taxonomy Address Enumeration
1639248461 Leah Jane Holmes Psychologist 1932 Viking Dr Nw, Rochester, MN 55901-2460 2006-11-07
1952467383 Victoria Marie Robison Registered Nurse 1932 Viking Dr Nw, Rochester, MN 55901-2460 2006-12-29
1417010117 Samuel Harold Fink Psychologist 1932 Viking Dr Nw, Rochester, MN 55901-2460 2006-12-18
1134281090 Joy Marie Alexander Clinical Nurse Specialist 1932 Viking Dr Nw, Rochester, MN 55901 2006-12-15
1891863197 Marie Joanna Davidiak Social Worker 1932 Viking Dr Nw, Rochester, MN 55901-2460 2006-12-04

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1417554627 Austin Montgomery Gray Chiropractor 4229 West Frontage Rd Nw, Suite 4, Rochester, MN 55901 2020-10-01
1497303150 Tatenda Valentine Rudziva Nurse Practitioner 2989 315 Elton Hills Drive Nw, Suite 201, Rochester, MN 55901 2019-08-27
1629566872 Juan Simon Rico Mesa Student in an Organized Health Care Education/Training Program 4502 Medical Drive, San Antonio, 78229, San Antonio, TX 55901 2018-04-24
1336658277 Minnesota Teen Challenge Exclusive Provider Organization 1542 Assisi Drive Nw, Rochester, MN 55901 2017-09-22
1235648270 Mariah Adanene Registered Nurse 915 41st Street Nw, Rochester, MN 55901 2017-09-21
1912420639 Anna Maria Schuman Speech-Language Pathologist 2746 Superior Drive Nw, Suite Number 150, Rochester, MN 55901 2017-07-25
1871013870 Rhonda Keith Counselor 602 11th Avenue Nw #300, Rochester, MN 55901 2017-06-21
1548794316 Trevor Kindle Ophthalmology 200 1st Ave Nw, Rochester, MN 55901 2017-04-18
1659810844 Rx Team Home Health Care LLC Home Health 1027 7th St Nw Unit #204, Rochester, MN 55901 2017-02-21
1457713109 Joshua Carter Chiropractor 3270 19th St Nw Ste 203, Rochester, MN 55901 2016-03-22
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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1346883873 Denise Pine Psychologist 1111 Elmwood Ave # D3, Rochester, NY 14620-3005 2019-10-28
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1275017550 Leah Rothschild Psychologist 160 Allens Creek Rd Ste 160, Rochester, NY 14618-3312 2018-09-21
1639658693 Garry Linsis Spink Jr. Psychologist 100 Pinewild Dr Fl 2, Rochester, NY 14606-4200 2018-08-10
1942798129 Rachel Marie Rodorigo Psychologist 900 W University Dr Ste B3, Rochester, MI 48307-1817 2018-04-24
1740799162 Douglas Andrew Raynor Psychologist 919 Winton Rd S Ste 106, Rochester, NY 14618-1633 2017-09-28
1356861884 Lauren P Wadsworth Psychologist 21 Goodway Dr, Rochester, NY 14623-3029 2017-06-26
1881120947 Dayton Walsh Psychologist 190 Goodman St S, Rochester, NY 14607-2651 2017-05-11
1770019713 Brenna Cavanaugh Psychologist 200 East River Rd., Rochester, NY 14623 2017-05-11
1275068470 Tara Marie Augenstein Psychologist University of Rochester, Dept. of Psychiatry, 300 Crittenden Blvd, Rochester, NY 14642 2017-04-25
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Competitor

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City ROCHESTER
Zip Code 55901

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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