Ms Kristin Anne Clark, is a
Social Worker - Clinical based in Gilroy, California. Ms Kristin Anne Clark is licensed to practice in California (license number 77878) and her current practice location is
290 Ioof Ave., Gilroy, California. She can be reached at her office (for appointments etc.) via phone at
(831) 466-6385.
NPI number for Ms Kristin Anne Clark is 1851468052 and her current mailing address is 4577 Prescott Rd, Soquel, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1851468052.
Healthcare Provider's Profile
| Full Name | Ms Kristin Anne Clark |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 290 Ioof Ave., Gilroy, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1851468052
- Provider Enumeration Date: 11/30/2006
- Last Update Date: 08/07/2017
Medical Identifiers
Medical identifiers for Ms Kristin Anne Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1851468052 | NPI | - | NPPES |
| 41807 | Other | CA | UNICARE NUMBER |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | 73118 (California) | Secondary |
| 104100000X | Social Worker | 29221 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | 77878 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Kristin Anne Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ms Kristin Anne Clark,
4577 Prescott Rd,
Soquel, CA 95073-9737
Ph: (760) 445-2382 | Ms Kristin Anne Clark,
290 Ioof Ave.,
Gilroy, CA 95020
Ph: (831) 466-6385 |
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