DR. CRAIG G CLARK (NPI# 1538262498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538262498 |
| Entity Type | Individual |
| Full Name | DR. CRAIG G CLARK |
| Credential | PH.D. |
| Practice Address |
1800 Fair Oaks Ave Ste A South Pasadena CA 91030-4775 |
| Mailing Address |
1800 Fair Oaks Ave Suite A South Pasadena CA 91030-4776 |
| Practice Telephone | 6264371432 |
| Practice Fax Number | 6263488317 |
| Mailing Telephone | 6264030734 |
| Mailing Fax Number | 6263518598 |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2018-12-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | PSY9239 | CA | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY9239 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE LICENSE | PSY9239 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821227547 | Craig Clark | Specialist/Technologist | Furman University Sports Med, 3300 Poinsett Highway, Greenville, SC 29613-0001 | 2009-07-02 |
| 1427222843 | Craig Alan Clark | Dietitian, Registered | 9301 Sw 92nd Ave, Apt. #a312, Miami, FL 33176-2142 | 2008-04-16 |
| 1780165696 | Craig Steven Clark | Counselor | 4027 County Road 25, St Louis Park, MN 55416 | 2018-08-28 |
| 1598163453 | Craig Y Clark | Registered Nurse | 149 Spurwink Rd, Scarborough, ME 04074-8607 | 2014-12-09 |
| 1386971984 | Craig G. Clark | Pharmacist | 4949 W Ray Rd, Chandler, AZ 85226-2064 | 2009-11-03 |
| 1245453034 | Craig William Clark | Marriage & Family Therapist | 100 N Winchester Blvd, Suite 264, Santa Clara, CA 95050-6520 | 2007-04-10 |
| 1497830186 | Craig Raymond Clark | Chiropractor | 3140 Red Hill Ave, #120, Costa Mesa, CA 92626-3400 | 2006-10-25 |
| 1164529186 | Craig Anthony Clark | Psychiatry & Neurology | 30 Burton Hills Blvd, Suite 375, Nashville, TN 37215-6140 | 2006-09-20 |
| 1326057852 | Craig D Clark | Orthopaedic Surgery | 825 Nw Highway 101 Ste A, Lincoln City, OR 97367-3241 | 2006-08-05 |
| 1487609111 | Craig Leo Clark | Pharmacist | 1946 42nd St Ne, Cedar Rapids, IA 52402 | 2006-05-23 |
| Street Address |
1800 FAIR OAKS AVE STE A |
| City | SOUTH PASADENA |
| State | CA |
| Zip Code | 91030-4775 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306444674 | Heather Marie Delman | Marriage & Family Therapist | 1425 Oneonta Knoll, So Pasadena, CA 91030 | 2020-10-09 |
| 1568986883 | Richard Gonzalez | Behavior Technician | 625 S Fair Oaks Ave #300, South Pasadena, CA 91030 | 2017-07-28 |
| 1366991150 | Nereida Acosta | Behavioral Analyst | 625 S Fair Oaks Ave, Suite 200, South Pasadena, CA 91030 | 2016-09-22 |
| 1043618192 | Clelia Alonzo | Specialist | 1317 Huntington Dr., Cos Services Building, South Pasadena, CA 91030 | 2014-12-05 |
| 1740687359 | Francisco Acosta | Behavioral Analyst | 625 S Fair Oaks Ave, Suite 300, South Pasadena, CA 91030 | 2014-11-25 |
| 1700289030 | James Y. Law | Pharmacist | 1678 Camino Lindo, S. Pasadena, CA 91030 | 2014-10-01 |
| 1760893994 | Joanna Ku | Rehabilitation Practitioner | 1855 Hill Drive, South Pasadena, CA 91030 | 2014-05-09 |
| 1336568294 | Sarah Sicher | Psychiatry & Neurology | 729 Mission St Ste 300, South Pasadena, CA 91030 | 2014-04-08 |
| 1265799530 | Xiaodong Li | Pathology | 314 Monterey Rd Unit 14, South Pasadena, CA 91030 | 2012-04-11 |
| 1831477124 | South Pasadena General Dentistry Inc | Dentist | 1506 Huntington Drive, South Pasadena, CA 91030 | 2011-08-03 |
| Find all providers in zip 91030 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811531775 | Janet M. Kelley, Ph.d. Inc | Psychologist | 1605 Hope St Ste 210, South Pasadena, CA 91030-2670 | 2019-11-04 |
| 1023212453 | Matthew Grant Calkins | Psychologist | 1515 Hope St Ste 202, South Pasadena, CA 91030-2610 | 2007-06-11 |
| 1346384286 | Tyson Chung | Psychologist | 625 Fair Oaks Ave Ste 390, South Pasadena, CA 91030-5817 | 2007-02-16 |
| 1780724179 | Jessica L Hess | Psychologist | 1137 Huntington Dr Ste A2, South Pasadena, CA 91030-4580 | 2007-02-07 |
| 1134225139 | Linda Lee Bortell | Psychologist | 625 Fair Oaks Ave Ste 270, South Pasadena, CA 91030-5801 | 2006-09-16 |
| 1699799437 | Catherine S Smith | Psychologist | 1605 Hope St, Suite 305, South Pasadena, CA 91030-2628 | 2006-07-26 |
| 1538707096 | Joseph Haig Dadourian | Psychologist | 1107 Fair Oaks Ave, #48, South Pasadena, CA 91030-3311 | 2019-12-16 |
| 1225563752 | Tmh Psychotherapy Corporation | Psychologist | 1605 Hope St, 335, South Pasadena, CA 91030-2628 | 2017-04-21 |
| 1639531312 | Iris Yolanda Lopez Luthi | Psychologist | 625 Fair Oaks Ave Ste 390, South Pasadena, CA 91030-5817 | 2016-03-22 |
| 1366812133 | Ferrer & Ho Psychology Corporation | Psychologist | 2130 Huntington Dr, Ste. 307, South Pasadena, CA 91030-4964 | 2015-10-05 |
| Find all providers in SOUTH PASADENA | ||||
| City | SOUTH PASADENA |
| Zip Code | 91030 |
Please comment or provide details below to improve the information on DR. CRAIG G 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.