Mr Andrew J Clark, is a
Counselor based in Santa Maria, California. Mr Andrew J Clark is licensed to practice in California (license number LEP3168) and his current practice location is
1219 Oak Knoll Rd, Santa Maria, California. He can be reached at his office (for appointments etc.) via phone at
(805) 268-5218.
NPI number for Mr Andrew J Clark is 1316215528 and his current mailing address is Po Box 2531, Santa Maria, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1316215528.
Healthcare Provider's Profile
| Full Name | Mr Andrew J Clark |
|---|
| Gender | Male |
|---|
| Speciality | Counselor |
|---|
| Location | 1219 Oak Knoll Rd, Santa Maria, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1316215528
- Provider Enumeration Date: 12/02/2011
- Last Update Date: 08/14/2019
Medical Identifiers
Medical identifiers for Mr Andrew J Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1316215528 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TS0200X | Psychologist - School | LEP3168 (California) | Secondary |
| 101Y00000X | Counselor | LEP3168 (California) | Primary |
| 101YS0200X | Counselor - School | LEP3168 (California) | Secondary |
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. Mr Andrew J 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 |
|---|
Mr Andrew J Clark,
Po Box 2531,
Santa Maria, CA 93457-2531
Ph: (805) 268-5218 | Mr Andrew J Clark,
1219 Oak Knoll Rd,
Santa Maria, CA 93455-4303
Ph: (805) 268-5218 |
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