DR. JUDITH Z CLARK (NPI# 1356440275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356440275 |
| Entity Type | Individual |
| Full Name | DR. JUDITH Z CLARK |
| Credential | PHD |
| Practice Address |
126 Old Mammoth Rd Suite 214 Mammoth Lakes CA 93546 |
| Mailing Address |
Po 100 Pmb 470 Mammoth Lakes CA 93546-0100 |
| Practice Telephone | 7609248503 |
| Practice Fax Number | 7609240541 |
| Mailing Telephone | 7609248503 |
| Mailing Fax Number | 7609240541 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2011-09-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY13963 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE PTAN | CP13963 | 01 |
| CA | PSY139630 | 05 | |
| AETNA | 11413861 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861717597 | Judith Ann Clark | Counselor | 244 Jefferson St, Lexington, KY 40508-1217 | 2010-04-06 |
| 1780682138 | Judith Cr Clark | Nurse Practitioner | 375 Briarwood Cir, Ann Arbor, MI 48108-1605 | 2005-07-11 |
| 1487941308 | Judith Clark | Social Worker | 91 Elm St, Westfield, MA 01085-2906 | 2011-06-29 |
| 1871884155 | Judith Yvette Clark | Nurse Practitioner | 10051 5th St N Ste 200, Saint Petersburg, FL 33702-2211 | 2011-04-21 |
| 1508191818 | Judith Alice Clark | Pharmacist | 10405 N La Canada Dr, Oro Valley, AZ 85737-6945 | 2009-10-05 |
| 1316117898 | Judith Lynn Clark | Physical Therapy Assistant | 6455 Pearl Rd, Parma Heights, OH 44130-2984 | 2008-03-11 |
| 1346421658 | Judith J Clark | Counselor | 1803 Oregon Pike, Lancaster, PA 17601-6401 | 2007-11-15 |
| 1740379098 | Judith Clark | Psychologist | 49 Pleasant St, Weymouth, MA 02190-2435 | 2006-10-12 |
| 1003928466 | Judith L Clark | Social Worker | 17273 State Route 104, Chillicothe, OH 45601-8608 | 2006-08-31 |
| Street Address |
126 OLD MAMMOTH RD SUITE 214 |
| City | MAMMOTH LAKES |
| State | CA |
| Zip Code | 93546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513433 | Luisana Beatriz Baires | Case Manager/Care Coordinator | 1290 Tavern Rd., Mammoth Lakes, CA 93546 | 2020-09-21 |
| 1679106371 | Jesica Jasmin Ramos Castelan | Case Manager/Care Coordinator | 365 Sierra Park Rd, Mammoth Lakes, CA 93546 | 2020-02-20 |
| 1669970224 | Andres Villalpando | Case Manager/Care Coordinator | 452 Old Mammoth Rd Suit 304, Mammoth Lakes, CA 93546 | 2018-01-30 |
| 1598278467 | Eastern Sierra Counseling and Consulting | Social Worker | 272 Sierra Manor, Suite B1, Mammoth Lakes, CA 93546 | 2017-11-14 |
| 1053771949 | Sofia Carolina Flores | Counselor | 451 Old Mammoth Rd, 304, Mammoth Lakes, CA 93546 | 2016-03-04 |
| 1669848180 | Jennifer Liebersbach | Chiropractor | 645 Old Mammoth Rd., Mammoth Lakes, CA 93546 | 2015-08-19 |
| 1316281918 | France Jacqueline Fischer | Behavioral Analyst | 2251 Meridian Blvd., Mammoth Lakes, CA 93546 | 2012-11-20 |
| 1366712424 | Richard Charles Bonneau | Counselor | 452 Old Mammoth Rd, 3rd Floor, Mammoth Lakes, CA 93546 | 2012-01-06 |
| 1407155435 | Mammoth Lakes Fire Protection District | Ambulance | 3150 Main Street, Mammoth Lakes, CA 93546 | 2011-03-16 |
| 1588964381 | Nancy Ellen Johnson | Pharmacist | 481 Old Mammoth Road, Mammoth Lakes, CA 93546 | 2010-10-26 |
| Find all providers in zip 93546 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134742414 | Callie Amanda Olpin | Psychologist | 1290 Tavern Road, Mammoth Lakes, CA 93546-2619 | 2020-05-21 |
| 1760701023 | Jacob Andrew Eide | Psychologist | 85 Sierra Park Rd, Mammoth Lakes, CA 93546 | 2010-05-26 |
| 1861516494 | Nancy Thomas Akalin | Psychologist | 85 Sierra Park Road, Mammoth Hospital, Mammoth Lakes, CA 93546 | 2007-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164023867 | Watson, Sanchez, & Navarro Psychological Group | Psychologist | 270 E 7th St Ste 1c, Upland, CA 91786-6602 | 2020-11-08 |
| 1558962324 | Marjan-marcia Khalitchi-alavi | Psychologist | 12400 Wilshire Blvd #230, Los Angeles, CA 90025 | 2020-11-06 |
| 1982203568 | Gautami Polepally Ashok | Psychologist | 1234 W Chapman Ave Ste 203, Orange, CA 92868-2863 | 2020-10-23 |
| 1851990626 | Sarah R Martin | Psychologist | 650 Charles E Young Dr S # 12-096, Los Angeles, CA 90095-8347 | 2020-10-22 |
| 1184223851 | Emily Jenchura | Psychologist | 11301 Wilshire Blvd (116b, Rm. A-130), Los Angeles, CA 90073 | 2020-10-22 |
| 1588261580 | Pamela J Newman | Psychologist | 3737 Elderberry Gln, Escondido, CA 92025-7910 | 2020-10-04 |
| 1689271785 | Michelle Sullivan | Psychologist | 2419 44th Ave, San Francisco, CA 94116-2062 | 2020-10-02 |
| 1184231730 | Joanna Lesley Kaye | Psychologist | 3555 Rosecrans St Ste 114-212, San Diego, CA 92110-3231 | 2020-09-28 |
| 1174130181 | Pamela F. Benyas | Psychologist | Dr. Pamela Benyas, 4419 Vans Nuys Bl #400, Sherman Oaks, CA 91403 | 2020-09-24 |
| 1730795634 | Maya Boustani | Psychologist | 5441 Dundee Ct, Rancho Cucamonga, CA 91739-2604 | 2020-09-17 |
| Find all providers with the same taxonomy | ||||
| City | MAMMOTH LAKES |
| Zip Code | 93546 |
Please comment or provide details below to improve the information on DR. JUDITH Z CLARK.
| 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.