Shelia Ann Clark, PHD is a medicare enrolled "Psychologist - Clinical" provider in Pine Mountain Club, California. Her current practice location is
2805 Rainier Way, Pine Mountain Club, California. You can reach out to her office (for appointments etc.) via phone at
(661) 644-3943.
Shelia Ann Clark is licensed to practice in California (license number PSY13425) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1982716254.
Healthcare Provider's Profile
| Full Name | Shelia Ann Clark |
|---|
| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 2805 Rainier Way, Pine Mountain Club, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1982716254
- Provider Enumeration Date: 08/31/2006
- Last Update Date: 03/02/2022
Medicare PECOS Information:
- PECOS PAC ID: 2769446665
- Enrollment ID: I20110121000743
Medical Identifiers
Medical identifiers for Shelia Ann Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1982716254 | NPI | - | NPPES |
| PSY134253 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | PSY13425 (California) | Secondary |
| 106H00000X | Marriage & Family Therapist | MFC23878 (California) | Secondary |
| 103TC0700X | Psychologist - Clinical | PSY13425 (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. Shelia Ann Clark is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Shelia Ann Clark, PHD
Po Box 1929,
Frazier Park, CA 93225-1929
Ph: (661) 644-3943 | Shelia Ann Clark, PHD
2805 Rainier Way,
Pine Mountain Club, CA 93222-6045
Ph: (661) 644-3943 |
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