PHILLIP A CLARK (NPI# 1568950764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568950764 |
| Entity Type | Individual |
| Full Name | PHILLIP A CLARK |
| Practice Address |
925 Brockhurst St Oakland CA 94608-4222 |
| Practice Telephone | 5109239600 |
| Mailing Telephone | 5109239600 |
| Mailing Fax Number | 5109239606 |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2018-04-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1962601666 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912451 | Phillip Douglas Clark Sr. | Home Health Aide | 2126 Highway 9 E Unit 5b, Longs, SC 29568-5725 | 2020-11-03 |
| 1629471412 | Phillip Wayne Clark | Nurse Practitioner | 150 E. Tyson Rd, Quartzsite, AZ 85359-4618 | 2014-10-07 |
| 1881838027 | Phillip J Clark | Counselor | 206 Lilly Rd Ne Apt B5, Olympia, WA 98506-5011 | 2009-04-30 |
| 1083272934 | Phillip Clark | Physical Therapy Assistant | 4560 Se International Way Ste 100, Milwaukie, OR 97222-4628 | 2019-06-04 |
| 1669991691 | Phillip Clark | Case Manager/Care Coordinator | 9403 Mansfield Rd, Shreveport, LA 71118-3815 | 2017-09-11 |
| 1194169144 | Phillip Don Clark | Radiology | 1924 Alcoa Hwy # U107, Knoxville, TN 37920-1511 | 2013-04-22 |
| Street Address |
925 BROCKHURST ST |
| City | OAKLAND |
| State | CA |
| Zip Code | 94608-4222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275690778 | Susan Elizabeth Werner | Social Worker | 925 Brockhurst St, Oakland, CA 94608-4222 | 2007-01-03 |
| 1760982003 | Shalom Spencer | Social Worker | 925 Brockhurst St, Oakland, CA 94608-4222 | 2018-02-13 |
| 1215461918 | Laruebetty Williams | Social Worker | 925 Brockhurst St, Oakland, CA 94608-4222 | 2017-04-19 |
| 1376996389 | Andrew Culler | Social Worker | 925 Brockhurst St, Oakland, CA 94608-4222 | 2016-07-14 |
| 1295131878 | Cherisse Y. Harper | Counselor | 925 Brockhurst St, Oakland, CA 94608-4222 | 2014-11-10 |
| 1467792879 | Caroline Corey Wilson | Case Manager/Care Coordinator | 925 Brockhurst St, Oakland, CA 94608 | 2013-02-21 |
| 1740520154 | Margaret Stenger | Social Worker | 925 Brockhurst St, Oakland, CA 94608 | 2013-02-21 |
| 1003156415 | Stacey Nicole Francis | Social Worker | 925 Brockhurst St, Oakland, CA 94608 | 2013-02-21 |
| 1023337243 | St. Mary's Center | Case Management | 925 Brockhurst St, Oakland, CA 94608-4222 | 2010-05-27 |
| 1801095302 | Mary Elizabeth Fisher | Social Worker | 925 Brockhurst St, Oakland, CA 94608-4222 | 2007-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396363610 | Francine Marie Madrid-bizari | Midwife | 5854 Fremont St, Oakland, CA 94608 | 2020-07-13 |
| 1457853921 | Jimmy Yan | Behavior Technician | 5900 Hollis Street Suite X, Emeryville, CA 94608 | 2018-03-01 |
| 1609395961 | Bay Wellness | Durable Medical Equipment & Medical Supplies | 5715 Market St Ste #d, Oakland, CA 94608 | 2017-09-18 |
| 1871023630 | Philip Staley | Registered Nurse | 1890 Alcatraz Avenue, Berkeley, CA 94608 | 2017-06-14 |
| 1114379120 | Leah Jane Tapscott | Registered Nurse | 6121 Hollis St Ste 900, Emeryville, CA 94608 | 2016-07-01 |
| 1295122273 | Paramjit S Virk | Nurse Practitioner | 888 Stanford Ave., Oakland, CA 94608 | 2015-04-17 |
| 1295123453 | Sports Injury Medical Group | Preferred Provider Organization | 5900 Hollis St., Suite K, Emeryville, CA 94608 | 2014-12-22 |
| 1144630583 | Adeline Lopez | Social Worker | 925 Brockhurst St., Oakland, CA 94608 | 2014-05-07 |
| 1710201603 | Rachna Gurjeet Wadia | Pediatrics | 6121 Hollis St. Suite #2, Emeryville, CALIFORNIA 94608 | 2010-03-21 |
| 1184872285 | I 5 Medical Group, Inc. | Clinic/Center | 5915 B Hollis Street, Emeryville, CA 94608 | 2008-09-03 |
| Find all providers in zip 94608 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760099832 | Marlena Sara Hartman-filson | Counselor | 422 38th St Apt A, Oakland, CA 94609-2778 | 2020-09-23 |
| 1801412689 | Lindsey Schwartz | Counselor | 7200 Bancroft Ave, Building B, Ste 133, Oakland, CA 94605-2480 | 2020-06-17 |
| 1013538487 | Alex Weinstein | Counselor | 4264 Norton Ave, Oakland, CA 94602-4018 | 2020-04-27 |
| 1700418001 | Thera Share | Counselor | 1714 Franklin St #411, Oakland, CA 94612 | 2020-02-05 |
| 1992342810 | Zoe Karanfilian | Counselor | 62 Vancleave Way, Oakland, CA 94619-2340 | 2019-12-10 |
| 1881154763 | Cia A Robles | Counselor | 3798 Grand Ave Ste 1, Oakland, CA 94610-1527 | 2019-03-25 |
| 1568927994 | Lynsey Scott | Counselor | Wiley Manuel Courthouse, 661 Washington St Rm223, Oakland, CA 94607 | 2019-02-11 |
| 1013489954 | Jasmine J Rutherford | Counselor | 3301 E 12th St Ste 116, Oakland, CA 94601-3424 | 2018-12-17 |
| 1366910549 | Raven Porter | Counselor | 2747 76th Ave, Oakland, CA 94605-2809 | 2018-11-06 |
| 1801363288 | Shane Smith | Counselor | 10401 Shaw St, Oakland, CA 94605-5116 | 2018-10-24 |
| Find all providers in OAKLAND | ||||
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| 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.