ANDREA MARIE CLARK (NPI# 1467639690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467639690 |
| Entity Type | Individual |
| Full Name | ANDREA MARIE CLARK |
| Practice Address |
1401 W 4th St Antioch CA 94509-1024 |
| Practice Telephone | 9257783750 |
| Practice Fax Number | 9257783750 |
| Mailing Telephone | 9257783750 |
| Mailing Fax Number | 9257783750 |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2009-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982182309 | Andrea K Clark | Occupational Therapist | 920 Goldenrod Ln, Hickman, NE 68372-9509 | 2018-07-30 |
| 1407238660 | Andrea Clark | Contractor | 2300 Seaman St, Apt. 101, Toledo, OH 43605-1952 | 2015-06-24 |
| 1114359049 | Andrea Clark | Physical Therapist | 531 Madison St, Albany, CA 94706-1116 | 2013-08-02 |
| 1003124223 | Andrea Nicole Clark | Licensed Practical Nurse | 9869 State Route 141, Kitts Hill, OH 45645-8649 | 2010-09-22 |
| 1295057362 | Andrea Serina Clark | Speech-Language Pathologist | 7497 Oak Tree Ln, Spring Hill, FL 34607-2324 | 2010-02-17 |
| 1336369602 | Andrea Walser Clark | Counselor | 157 Walser Way, Advance, NC 27006-7341 | 2007-04-27 |
| 1912034596 | Andrea Rachele Clark | Psychologist | 1818 W Lindsey St Ste C120, Norman, OK 73069-4169 | 2007-02-28 |
| 1477593580 | Andrea Clark | Counselor | 120 W 57th St, 8th Floor, New York, NY 10019-3320 | 2006-06-07 |
| 1558999672 | Andrea Clark | Registered Nurse | 1155 Dairy Ashford Rd Ste 560, Houston, TX 77079-3035 | 2020-04-01 |
| 1306359948 | Andrea Clark | Counselor | 10 Southard St, Trenton, NJ 08609-1020 | 2017-11-06 |
| Street Address |
1401 W 4TH ST |
| City | ANTIOCH |
| State | CA |
| Zip Code | 94509-1024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912363649 | Jennifer Hernandez | Counselor | 1401 W 4th St, Antioch, CA 94509-1024 | 2016-01-11 |
| 1306216692 | Shanna Boulden | Counselor | 1401 W 4th St, Antioch, CA 94509-1024 | 2015-09-30 |
| 1497130041 | Tiffany Heneby | Counselor | 1401 W 4th St, Antioch, CA 94509-1024 | 2015-07-24 |
| 1154706711 | Michelle Amaral | Counselor | 1401 W 4th St, Antioch, CA 94509-1024 | 2015-07-24 |
| 1295124972 | Lisa Maire Michel | Counselor | 1401 W 4th St, Antioch, CA 94509-1024 | 2015-01-17 |
| 1558774323 | Adam Morris | Counselor | 1401 W 4th St, Antioch, CA 94509-1024 | 2014-06-09 |
| 1649696220 | Shirley Jean Struasbaugh | Counselor | 1401 W 4th St, Antioch, CA 94509-1024 | 2014-03-06 |
| 1114289006 | Anthony Ruben Arasa | Counselor | 1401 W 4th St, Antioch, CA 94509-1024 | 2012-06-15 |
| 1366745473 | Edward William Tadros | Counselor | 1401 W 4th St, Antioch, CA 94509-1024 | 2010-12-10 |
| 1952603953 | Rebecca Noel Sanders | Counselor | 1401 W 4th St, Antioch, CA 94509-1024 | 2010-11-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932733243 | A Step Above, LLC | Clinic/Center | 3648 Delta Fair Blvd., Antioch, CA 94509 | 2020-02-25 |
| 1134751167 | Dr. Jeffrey A Saladin, Dental Corporation | Dentist | 3600 Delta Fair Blvd, Antioch, CA 94509 | 2020-02-07 |
| 1962040865 | Melay Goitom | Behavioral Analyst | 3104 Delta Fair Boulevard, Antioch, CA 94509 | 2019-12-11 |
| 1518525062 | James Joseph Cook | Counselor | 624 W. 14th Street B, Antioch, CA 94509 | 2019-05-30 |
| 1922576438 | Wazma Matiee | Behavioral Analyst | 2009 Asilomar Dr., Antioch, CA 94509 | 2018-11-02 |
| 1346722360 | Dharma Rachelle Yancy | Behavioral Analyst | 3401 Delta Fair Blvd, Antioch, CA 94509 | 2018-09-06 |
| 1912489931 | Cristian Cruz | Behavioral Analyst | 3100-3104 Delta Fair Blvd, Antioch, CA 94509 | 2018-09-06 |
| 1780174052 | Melissa Sue Rossi | Counselor | 3701 Lone Tree Way Ste 7a, Antioch, CA 94509 | 2018-05-13 |
| 1033638085 | Elizabeth Marie Artola | Counselor | 1915 D Street, Antioch, CA 94509 | 2017-09-11 |
| 1144748690 | Andrea Michelle Newberry | Counselor | 55 E.18th St, Antioch, CA 94509 | 2017-09-05 |
| Find all providers in zip 94509 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720699648 | Khamaria Wright | Counselor | 5160 Rice Rd Apt 236, Antioch, TN 37013-2041 | 2020-08-13 |
| 1316562580 | Joseph James Benton | Counselor | 2495 Vallecito Way, Antioch, CA 94531-9066 | 2020-06-12 |
| 1902381593 | New Leaf Counseling LLC | Counselor | 311 W Depot St Ste F, Antioch, IL 60002-1500 | 2018-09-28 |
| 1144748690 | Andrea Michelle Newberry | Counselor | 55 E.18th St, Antioch, CA 94509 | 2017-09-05 |
| 1629420013 | Jessica Rivers | Counselor | 1480 Rice Hill Cir, Antioch, TN 37013-2199 | 2016-07-08 |
| 1518313055 | Alisha Lampley | Counselor | 804 Thomas Bay Court, Antioch, TN 37013 | 2016-05-13 |
| 1376909341 | Toy Lisa Mitchell | Counselor | 4804 Trappers Rdg, Antioch, TN 37013-2707 | 2016-01-06 |
| 1386019602 | Abdullah Hassaan | Counselor | 3304 Timber Trl, Antioch, TN 37013-1011 | 2015-12-11 |
| 1114399219 | Glory Kosmatka | Counselor | 800 Main St Ste 5, Antioch, IL 60002-1542 | 2015-10-28 |
| 1528459344 | Jared Prentiss | Counselor | 5320 Hickory Hollow Pkwy, Antioch, TN 37013-3128 | 2015-02-16 |
| Find all providers in ANTIOCH | ||||
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| 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.