DR. CLARENCE GLENN III (NPI# 1114413523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114413523 |
| Entity Type | Individual |
| Full Name | DR. CLARENCE GLENN III |
| Credential | MD, MBA |
| Practice Address |
4211 Avalon Blvd Los Angeles CA 90011-5622 |
| Mailing Address |
702 S St Andrews Pl Apt 8 Los Angeles CA 90005-3145 |
| Practice Telephone | 3232330425 |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2020-10-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
A167345 | CA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
4211 AVALON BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90011-5622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316034671 | Sohini Parikh | Psychiatry & Neurology | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2006-10-06 |
| 1427659382 | Dana Thomas | Social Worker | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2020-11-05 |
| 1487254488 | Destiny Marie Lara | Case Manager/Care Coordinator | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2020-10-28 |
| 1538767215 | Shira Amiri | Social Worker | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2020-10-14 |
| 1053927301 | Luz Elena Nunez | Social Worker | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2020-09-22 |
| 1740895168 | Veronica Isaac | Case Manager/Care Coordinator | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2020-09-11 |
| 1356952881 | Emily Wakeling | Counselor | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2020-08-10 |
| 1336758770 | Diana Ramos | Case Manager/Care Coordinator | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2020-07-30 |
| 1679199632 | Erin Hayden | Counselor | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2020-06-24 |
| 1861013344 | Katherine Rivas De Ollett | Nurse Practitioner | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2020-05-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184223935 | Commercial & Housing Support Aid | Assisted Living Facility | 120 - 122 East 24th Street, Los Angeles, CA 90011 | 2020-10-22 |
| 1295377711 | Joseph D Madrigal | Home Health Aide | 1977 Anzac Ave, Los Angeles, CA 90011 | 2019-10-16 |
| 1538641212 | Brenda Bahena | Community Health Worker | South Central Family Health Center, 4425 S. Central Ave, Los Angeles, CA 90011 | 2018-08-30 |
| 1083101851 | Bronwyn Anne Hazlewood | Student in an Organized Health Care Education/Training Program | 3740 Maple Ave, 1/2 B, Los Angeles, CA 90011 | 2018-04-17 |
| 1164941183 | Kimberly Denise Lister- Gutierrez | Counselor | 303 E 52nd Street, Los Angeles, CA 90011 | 2017-09-11 |
| 1205252533 | Jameese B Smith | Case Manager/Care Coordinator | 271 E. 43rd Street, Los Angeles, CA 90011 | 2014-03-11 |
| 1033533153 | Avalon-carver Community Center | Community/Behavioral Health | 4920 S. Avalon Blvd, Los Angeles, CA 90011 | 2014-02-10 |
| 1245672500 | Kellie D Bougard | Student in an Organized Health Care Education/Training Program | 4920 South Avalon Blvd, Los Angeles, CA 90011 | 2013-07-26 |
| 1578909404 | Ma. Jasmin F Binas | Nurse Practitioner | 2707 S.central Ave., Los Angeles, CA 90011 | 2013-05-19 |
| 1912343344 | California Assisted Pharmacy, Inc | Pharmacy | 646 E 28th St, Ste #1, Los Angeles, CA 90011 | 2013-05-13 |
| Find all providers in zip 90011 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831705383 | Joel A Badeaux, Md, A Professional Corp | Psychiatry & Neurology | 2135 Park Dr, Los Angeles, CA 90026-1919 | 2020-09-21 |
| 1205454204 | Sage Minds | Psychiatry & Neurology | 3860 Wilshire Blvd, P04-1188, Los Angeles, CA 90010 | 2020-07-07 |
| 1881241453 | Bryan Yang Md Inc | Psychiatry & Neurology | 2221 W Olympic Blvd Ste 200, Los Angeles, CA 90006-2117 | 2019-08-19 |
| 1962063859 | Nida Kichkla | Psychiatry & Neurology | 1010 N Avenue 66, Los Angeles, CA 90042-1512 | 2019-06-22 |
| 1669976874 | Pulse Tms, A Medical Corporation | Psychiatry & Neurology | 1663 Sawtelle Blvd Ste 240, Los Angeles, CA 90025-3198 | 2018-03-21 |
| 1376047670 | Sasha Getty | Psychiatry & Neurology | 11301 Wilshire Blvd Rm 6428, Los Angeles, CA 90073-1003 | 2018-03-21 |
| 1972038388 | Eric Michael | Psychiatry & Neurology | 11301 Wilshire Blvd Bldg 401, Los Angeles, CA 90073-1003 | 2017-04-23 |
| 1386175941 | Christopher Junpyo Hong | Psychiatry & Neurology | 2250 Alcazar St # 2200, Los Angeles, CA 90089-2498 | 2017-03-24 |
| 1558892638 | David Zhang | Psychiatry & Neurology | 760 Westwood Plz Ste 17-413, Los Angeles, CA 90024-5055 | 2017-03-21 |
| 1306399951 | Gotham Psychiatric PC | Psychiatry & Neurology | 5419 Hollywood Blvd Ste C172, Los Angeles, CA 90027-3480 | 2016-08-01 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90011 |
Please comment or provide details below to improve the information on DR. CLARENCE GLENN 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.