WILLIAM DEANGELO CLARK (NPI# 1124246194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124246194 |
| Entity Type | Individual |
| Full Name | WILLIAM DEANGELO CLARK |
| Practice Address |
3850 Crenshaw Blvd Los Angeles CA 90008-1821 |
| Practice Telephone | 3237513026 |
| Mailing Telephone | 3237513026 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-09-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225400000X | Rehabilitation Practitioner | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8019 Compton Ave, Los Angeles, CA 900013409 | 3235867333 | 3233191998 |
| 2620 Industry Way, Lynwood, CA 902624024 | 3106674070 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447819677 | William Eugene Clark | Nurse's Aide | 2869 Howey Rd, Columbus, OH 43224-4028 | 2019-06-11 |
| 1528454154 | William Clark | Specialist/Technologist | 8501 Silverbrook Rd, Lorton, VA 22079-3015 | 2015-04-10 |
| 1639575830 | William Clark | Specialist/Technologist | 7 Reef Rd, Anderson, GU 83901 | 2014-11-15 |
| 1730423278 | William Douglas Clark | Mechanotherapist | 1617 Highway 20 W, Mcdonough, GA 30253-7311 | 2012-11-21 |
| 1487950606 | William D Clark | Massage Therapist | 1160 Lucerne Loop Rd Ne, Winter Haven, FL 33881-9681 | 2011-02-04 |
| 1124320692 | William Warren Clark | Recreation Therapist | 2118 Stagecoach Trl, Temple, TX 76502-3224 | 2010-12-03 |
| 1407093875 | William Todd Clark | Specialist/Technologist, Other | 305 Greenbriar Ct, Otisco, IN 47163-9601 | 2009-01-07 |
| 1922244524 | William J Clark | Technician/Technologist | 3984 Drexel Rd, Pittsburgh, PA 15212-1512 | 2009-01-02 |
| 1023274503 | William Dave Clark | Counselor | 1421 Ossahatchie Creek Rd, Ellerslie, GA 31807-5339 | 2008-08-04 |
| 1598938219 | William Little Clark | Orthopaedic Surgery | 5 Retreat Rd, Augusta, GA 30909-1837 | 2008-04-03 |
| Street Address |
3850 CRENSHAW BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90008-1821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083743082 | Southern California Health & Rehabilitation Program | Community/Behavioral Health | 3850 Crenshaw Blvd, Los Angeles, CA 90008-1821 | 2007-03-05 |
| 1518568500 | Ashlyn Marie Harris | Case Manager/Care Coordinator | 3850 Crenshaw Blvd, Los Angeles, CA 90008-1821 | 2020-11-05 |
| 1487261822 | Christian Rosales | Case Manager/Care Coordinator | 3850 Crenshaw Blvd, Los Angeles, CA 90008-1821 | 2020-09-29 |
| 1376158626 | Aldo Hernandes Rondan | Case Manager/Care Coordinator | 3850 Crenshaw Blvd, Los Angeles, CA 90008-1821 | 2020-09-14 |
| 1295351450 | Brittney Ray | Case Manager/Care Coordinator | 3850 Crenshaw Blvd, Los Angeles, CA 90008-1821 | 2020-06-23 |
| 1497370860 | Kimberly Denisse Turcios | Counselor | 3850 Crenshaw Blvd, Los Angeles, CA 90008-1821 | 2020-06-11 |
| 1104441872 | Tymon Jair Culberson-smith | Case Manager/Care Coordinator | 3850 Crenshaw Blvd, Los Angeles, CA 90008-1821 | 2020-06-09 |
| 1679196406 | Kennard Al-zahir Harris | Case Manager/Care Coordinator | 3850 Crenshaw Blvd, Los Angeles, CA 90008-1821 | 2020-05-27 |
| 1053947531 | Eric Dean Meza | Case Manager/Care Coordinator | 3850 Crenshaw Blvd, Los Angeles, CA 90008-1821 | 2020-03-17 |
| 1386278760 | Rachel D Garcia | Counselor | 3850 Crenshaw Blvd, Los Angeles, CA 90008-1821 | 2020-02-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376185215 | Mishanda Y Freeman | Social Worker | 3001 West Vernon Ave, Los Angeles, CA 90008 | 2019-10-11 |
| 1104390723 | Joana Rodriguez | Rehabilitation Practitioner | 3731 Stocker St., Suite 105, Los Angeles, CA 90008 | 2019-01-16 |
| 1356840128 | Acclivity | Community/Behavioral Health | 3870 Crenshaw Blvd Ste 229, Los Angeles, CA 90008 | 2018-02-07 |
| 1376055145 | Gentle F Carcamo | Rehabilitation Practitioner | 3731 Stoker Street, Ste. 105, Los Angeles, CA 90008 | 2017-11-01 |
| 1710498332 | The Dream Catcher Foundation, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 4173 2nd Ave, Los Angeles, CA 90008 | 2017-10-23 |
| 1144748591 | Alexandra Nicole Romero | Social Worker | 3751 Stocker St., Los Angeles, CA 90008 | 2017-09-06 |
| 1669998209 | Leslie S Ortiz | Counselor | 3731 Stocker Street, Suite 105, Los Angeles, CA 90008 | 2017-08-15 |
| 1902335078 | Deanna L Williams | Counselor | 3757 Santa Rosalia Drive, #628, Los Angeles, CA 90008 | 2017-06-12 |
| 1609300508 | Lydia Quintanills | Counselor | 3756 Santa Rosalia Dr Suite 617, Los Angeles, CA 90008 | 2017-04-18 |
| 1881056661 | A Plus Care Giver Services | Clinic/Center | 2420 W. Mlk Jr. Blvd, Los Angeles, CA 90008 | 2016-03-22 |
| Find all providers in zip 90008 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285242594 | Rocio Jimenez | Case Manager/Care Coordinator | 4650 Sunset Blvd, Mailstop #53, Los Angeles, CA 90027 | 2020-07-22 |
| 1245855725 | Ashley Ivette Berumen | Case Manager/Care Coordinator | 1900 W Slauson Ave, Los Angeles, CA 90047-1129 | 2020-06-10 |
| 1356965776 | Jennifer Yanovski | Case Manager/Care Coordinator | 316 W 2nd St Ste 202, Los Angeles, CA 90012-3527 | 2020-06-01 |
| 1841820560 | Kiara Imani Thomas | Case Manager/Care Coordinator | 226 E 103rd St, Los Angeles, CA 90003-4720 | 2020-01-22 |
| 1023648748 | Christopher Rivas | Case Manager/Care Coordinator | 1410 N Kenmore Ave Apt 5, Los Angeles, CA 90027-5826 | 2020-01-22 |
| 1396383782 | Candace Laolagi | Case Manager/Care Coordinator | 246 E 47th St, Los Angeles, CA 90011-3908 | 2019-12-16 |
| 1902448343 | Aster Libasu | Case Manager/Care Coordinator | 2619 Wilshire Blvd Apt 1005, Los Angeles, CA 90057-3461 | 2019-10-16 |
| 1831749456 | Jasmine Lynn Martinez | Case Manager/Care Coordinator | 6768 Lexington Ave, Los Angeles, CA 90038-1234 | 2019-09-16 |
| 1033762547 | John Charles Gutierrez | Case Manager/Care Coordinator | 4265 S Normandie Ave, Los Angeles, CA 90037-2324 | 2019-07-23 |
| 1609429976 | Vianey Colon | Case Manager/Care Coordinator | 11601 S Western Ave # O, Los Angeles, CA 90047-5006 | 2019-07-16 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90008 |
Please comment or provide details below to improve the information on WILLIAM DEANGELO CLARK.
| 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.