MR. GLEN ANTONIO CLARK III (NPI# 1952585218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952585218 |
| Entity Type | Individual |
| Full Name | MR. GLEN ANTONIO CLARK III |
| Practice Address |
1301 Pierce St. San Francisco CA 94115 |
| Mailing Address |
1153 Oak St. San Francisco CA 94117 |
| Practice Telephone | 4155638200 |
| Practice Fax Number | 5106442044 |
| Mailing Telephone | 4154319000 |
| Mailing Fax Number | 4154311813 |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2018-10-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740339233 | Glen Thomas Clark | Dentist | 925 W 34th St, Room #151, Los Angeles, CA 90089-0641 | 2007-01-10 |
| 1932110657 | Glen T Clark | Emergency Medicine | 468 Cadieux Rd, Grosse Pointe, MI 48230-1507 | 2006-08-10 |
| Street Address |
1301 PIERCE ST. |
| City | SAN FRANCISCO |
| State | CA |
| Zip Code | 94115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164879425 | Lisa Harol Wood | Counselor | 1301 Pierce St., San Francisco, CA 94115 | 2016-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619593274 | Francene G Colvin | Psychologist | 1939 Divisadero, Suite 1, San Francisco, CA 94115 | 2020-06-19 |
| 1760015689 | Simon James Little | Psychiatry & Neurology | 1634 Divisadero St, Suite 250, San Francisco, CA 94115 | 2020-02-19 |
| 1881243822 | Clara Kwun | Social Worker | 1610 Scott St., San Francisco, CA 94115 | 2019-09-11 |
| 1467005207 | Tamara Aline Hostetler | Marriage & Family Therapist | 2859 Sacramento St., San Francisco, CA 94115 | 2019-07-22 |
| 1962054999 | Wendy Lynne Stern | Psychologist | 2104 Bush St., San Francisco, CA 94115 | 2019-07-10 |
| 1184188476 | Katherine Marie Carroll | Specialist/Technologist | 1731 B Buchanan Street, San Francisco, CA 94115 | 2019-01-30 |
| 1710467410 | Joanna Katherine Hendrick | Marriage & Family Therapist | 1201 Fillmore Street, San Francisco, CA 94115 | 2018-08-21 |
| 1063998771 | Leonard Cheung | Counselor | Youth Services Bureau of San Francisco, 1426 Fillmore Street Suite 216, San Francisco, CA 94115 | 2018-07-16 |
| 1942709563 | Jobelle Cunanan | Behavior Technician | 1871 Turk St, San Francisco, CA 94115 | 2018-02-09 |
| 1083128235 | Dr. Jenny Mann, Nd | Clinic/Center | 2300 Sutter St Ste 301, San Francisco, CA 94115 | 2017-11-27 |
| Find all providers in zip 94115 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548869266 | Yama Totakhail | Counselor | 915 Bryant St # 94103, San Francisco, CA 94103-4514 | 2020-10-23 |
| 1619581956 | Jamie Marion Brown | Counselor | 1233 Noriega St Apt 4, San Francisco, CA 94122-4455 | 2020-09-03 |
| 1154931970 | Dagmawit Aberham Negash I | Counselor | 1735 Mission St. San Francisco, Ca, San Francisco, CA 94103-2417 | 2020-08-06 |
| 1710503420 | Seville Christian | Counselor | 75 Dore St Apt 107, San Francisco, CA 94103-3892 | 2020-06-18 |
| 1326673773 | Jeffrey Douglas Washington | Counselor | 1040 Sutter St Apt 56, San Francisco, CA 94109-5833 | 2020-03-05 |
| 1801429253 | Domenique Marie Stern | Counselor | 1049 Market St Apt 603, San Francisco, CA 94103-1635 | 2020-02-13 |
| 1487123436 | Judith St Louis-schmidt | Counselor | 735 Taylor St # 208, San Francisco, CA 94108-3807 | 2018-11-20 |
| 1114405495 | Angela Christina Thomas | Counselor | 1633 Newcomb Ave, San Francisco, CA 94124-2318 | 2018-07-30 |
| 1497231765 | Tsz Ching Isaac Chung | Counselor | 2020 Hayes Street, San Francisco, CA 94117 | 2018-07-19 |
| 1265923353 | Benjamin Adam Schaeffer | Counselor | 440 Potrero Ave Fl 2, San Francisco, CA 94110-1430 | 2018-05-23 |
| Find all providers in SAN FRANCISCO | ||||
| City | SAN FRANCISCO |
| Zip Code | 94115 |
Please comment or provide details below to improve the information on MR. GLEN ANTONIO CLARK III.
| 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.