KENNETH L CLARK (NPI# 1942344031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942344031 |
| Entity Type | Individual |
| Full Name | KENNETH L CLARK |
| Credential | RN |
| Practice Address |
2640 Breslauer Way Redding CA 96001-4246 |
| Mailing Address |
Po Box 496048 Redding CA 96049-6048 |
| Practice Telephone | 5302255233 |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
RN308125 | CA | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275056889 | Kenneth Clark | Hearing Instrument Specialist | 304 E Broadway St Ste 20, Mount Pleasant, MI 48858-2364 | 2017-07-25 |
| 1063887834 | Kenneth Eugene Clark | Occupational Therapy Assistant | 4885 Eldon Dr S, Colorado Springs, CO 80916-4431 | 2015-12-04 |
| 1821119959 | Kenneth R Clark | Pharmacist | 4211 Hospital St Ste 104, Pascagoula, MS 39581-5310 | 2007-04-03 |
| 1104487149 | Kenneth John Clark | Hearing Instrument Specialist | 462 Roosevelt Rd, Glen Ellyn, IL 60137-5611 | 2019-06-20 |
| 1144740580 | Kenneth John Clark Jr. | Physical Therapist | 6119 Deltona Blvd, Spring Hill, FL 34606-1011 | 2017-06-27 |
| 1619336229 | Kenneth Clark | Dentist | 2524 Hillside Heights Dr, Green Bay, WI 54311-6777 | 2016-02-11 |
| 1669878443 | Kenneth Clark | Registered Nurse | 724 N Charlotte St, Pottstown, PA 19464-4607 | 2014-11-06 |
| 1598046401 | Kenneth Dale Clark | Orthotist | 9303 Pinecroft Dr, The Woodlands, TX 77380-3181 | 2011-09-06 |
| 1093012783 | Kenneth Howard Clark | Pathology | 200 Lothrop St, Pittsburgh, PA 15213-2536 | 2011-02-16 |
| 1568794725 | Kenneth Andrew Clark II | Marriage & Family Therapist | 10800 Financial Centre Pkwy Ste 290, Little Rock, AR 72211-3581 | 2010-02-12 |
| Street Address |
2640 BRESLAUER WAY |
| City | REDDING |
| State | CA |
| Zip Code | 96001-4246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881692390 | County of Shasta | Community/Behavioral Health | 2640 Breslauer Way, Redding, CA 96001-4246 | 2005-07-08 |
| 1962018416 | Jacob Nathaniel Mccoard | Case Manager/Care Coordinator | 2640 Breslauer Way, Redding, CA 96001-4246 | 2020-09-21 |
| 1871109322 | Lovely Lobo | Registered Nurse | 2640 Breslauer Way, Redding, CA 96001-4246 | 2020-09-21 |
| 1477167138 | Shelly Bennett | Case Manager/Care Coordinator | 2640 Breslauer Way, Redding, CA 96001-4246 | 2020-09-01 |
| 1033727896 | Rachel Puleo-chankin | Assistant Behavior Analyst | 2640 Breslauer Way, Redding, CA 96001-4246 | 2020-07-17 |
| 1518593078 | Teaanna Wood | Case Manager/Care Coordinator | 2640 Breslauer Way, Redding, CA 96001-4246 | 2020-03-17 |
| 1992331789 | Juanita L Garcia | Counselor | 2640 Breslauer Way, Redding, CA 96001-4246 | 2020-03-12 |
| 1306486469 | Charles Markham | Case Manager/Care Coordinator | 2640 Breslauer Way, Redding, CA 96001-4246 | 2020-01-07 |
| 1215574165 | Karah Annmarie Harbuck | Case Manager/Care Coordinator | 2640 Breslauer Way, Redding, CA 96001-4246 | 2019-12-10 |
| 1437796372 | Chante Charae Hopper | Case Manager/Care Coordinator | 2640 Breslauer Way, Redding, CA 96001-4246 | 2019-12-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730651266 | Vanessa Louise Banda | Social Worker | 1544 Magnolia Avenue, Redding, CA 96001 | 2018-12-21 |
| 1184194672 | Marie Sherrick | Licensed Vocational Nurse | 2030 Elreno Lane, Redding, CA 96001 | 2018-11-28 |
| 1699257857 | Prorehab Physical Therapy and Sports Performance, Inc | Physical Therapist | 3673 Eureka Way, Redding, CA 96001 | 2018-09-05 |
| 1316456833 | Jennifer Rose Goehring | Counselor | 1310 Continental Street, Redding, CA 96001 | 2017-09-27 |
| 1891224440 | Audrey Cutler | Social Worker | 1313 Yuba St., Redding, CA 96001 | 2017-06-07 |
| 1184167991 | Calafia Holdings LLC | Skilled Nursing Facility | 1836 Gold Street, Redding, CA 96001 | 2016-11-28 |
| 1194272369 | Shasta County | Clinic/Center | 2950 Polk Street, Rooms 2, 3, 4, Redding, CA 96001 | 2016-09-06 |
| 1417329236 | Shari Hayden | Specialist/Technologist, Other | 2111 Air Park Dr, Redding, CA 96001 | 2015-10-21 |
| 1679951982 | Shasta Hearing Aids | Health Maintenance Organization | 900 Butte St, Redding, CA 96001 | 2015-05-07 |
| 1073919171 | Native American Mental Health Services Corporation | Psychiatry & Neurology | 1742 Oregon Street, Redding, CA 96001 | 2014-11-17 |
| Find all providers in zip 96001 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326433533 | Elora Liane Ong | Registered Nurse | 2640 Breslauer Way, Redding, CA 96001-4246 | 2015-04-03 |
| 1386907301 | Tymara Lynn Reep | Registered Nurse | 2640 Breslauer Way, Redding, CA 96001-4246 | 2012-06-25 |
| 1083980445 | Sharon Marie Erington | Registered Nurse | 2640 Breslauer Way, Redding, CA 96001-4246 | 2012-03-29 |
| 1124393889 | Leah Graesser | Registered Nurse | 2640 Breslauer Way, Redding, CA 96001-4246 | 2012-03-14 |
| 1316212228 | Jeffery Alan Nelson | Registered Nurse | 2640 Breslauer Way, Redding, CA 96001-4246 | 2012-03-12 |
| 1033483797 | Michelle Morris | Registered Nurse | 2640 Breslauer Way, Redding, CA 96001-4246 | 2012-02-28 |
| 1902194772 | Craig Louis Ackerman | Registered Nurse | 2640 Breslauer Way, Redding, CA 96001-4246 | 2011-07-14 |
| 1881983542 | Nathalie Marie Kuhn | Registered Nurse | 2640 Breslauer Way, Redding, CA 96001-4246 | 2011-04-04 |
| 1689814238 | Laura Marie Speirs Gendreau | Registered Nurse | 2640 Breslauer Way, Redding, CA 96001-4246 | 2009-02-23 |
| 1174761910 | Shari Lynn Maraviov | Registered Nurse | 2640 Breslauer Way, Redding, CA 96001-4246 | 2009-02-02 |
| Find all providers in REDDING | ||||
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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.