MR. ANDREW PAUL CLACK (NPI# 1578903175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578903175 |
| Entity Type | Individual |
| Full Name | MR. ANDREW PAUL CLACK |
| Other Name | MR. ANDY PAUL CLACK |
| Credential | MA |
| Practice Address |
9330 Baseline Rd Ste 102 Rancho Cucamonga CA 91701 |
| Mailing Address |
9330 Baseline Rd Ste 102 Rancho Cucamonga CA 91701-5827 |
| Practice Telephone | 9512352372 |
| Practice Fax Number | 9099812210 |
| Mailing Telephone | 9512352372 |
| Mailing Fax Number | 9099812210 |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2018-09-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 96297 | CA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 12968 Frederick St Ste A, Moreno Valley, CA 925535229 | 9512477077 |
| Street Address |
9330 BASELINE RD STE 102 |
| City | RANCHO CUCAMONGA |
| State | CA |
| Zip Code | 91701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164739595 | Andrea G Moore-emmett | Counselor | 9330 Baseline Rd Ste 102, Rancho Cucamonga, CA 91701 | 2010-09-07 |
| 1891276671 | Stepanian Family Counseling Inc | Marriage & Family Therapist | 9330 Baseline Rd Ste 102, Rancho Cucamonga, CA 91701-5827 | 2018-08-28 |
| 1982071122 | Jeffrey Samuel White | Marriage & Family Therapist | 9330 Baseline Rd Ste 102, Rancho Cucamonga, CA 91701-5827 | 2015-08-24 |
| 1306186291 | Nicholle Stepanian | Marriage & Family Therapist | 9330 Baseline Rd Ste 102, Rancho Cucamonga, CA 91701-5827 | 2013-02-28 |
| 1245522119 | Jennifer Lynne Nash-naiyer | Marriage & Family Therapist | 9330 Baseline Rd Ste 102, Rancho Cucamonga, CA 91701 | 2011-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558884882 | Alinda Joan Kniss | Speech-Language Pathologist | 8990 19 Th Street #304, Alta Loma, CA 91701 | 2017-07-19 |
| 1053548644 | Suniel S. Khemlani | Family Medicine | 11398 Kenyon Way Ste J, Rancho Cucamonga, CA 91701 | 2009-06-22 |
| 1215130448 | C Mark Keen | Dentist | 9606 Baseline Rd, Alta Loma, CA 91701 | 2007-06-06 |
| 1184845711 | Andrew Liu | Specialist/Technologist | 11801 Lark Dr., Rancho Cucamonga, CA 91701 | 2007-05-01 |
| 1083741359 | Rockcreek, Inc. | Intermediate Care Facility, Mentally Retarded | 10227 Monte Vista Street, Rancho Cucamonga, CA 91701 | 2007-02-27 |
| 1194867788 | George Ji Jun Tao | Dentist | 6626 Carnelian St, Alta Loma, CA 91701 | 2007-02-12 |
| 1265590624 | Terry F Brock | Dentist | 7283 Carnelian St, Alta Loma, CA 91701 | 2006-12-05 |
| 1851461354 | Dr Tom Dental Office | Dentist | 6795 Carnelian St, Alta Loma, CA 91701 | 2006-11-09 |
| 1124127956 | Johnny S Liu | Dentist | 7168 Archibald Ave, Suite 200, Alta Loma, CA 91701 | 2006-09-21 |
| 1396882643 | Acel Johnston | Marriage & Family Therapist | 8253 White Oak Ave, Rancho Cucamonga, CA 91701 | 2007-01-30 |
| Find all providers in zip 91701 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275810 | Milestone Marriage and Family Therapy Services Professional Corporati | Marriage & Family Therapist | 10601 Civic Center Dr Ste 100a-d, Rancho Cucamonga, CA 91730-3878 | 2020-11-04 |
| 1447859020 | Village Mental Health Group LLC | Marriage & Family Therapist | 11755 Malaga Dr Unit 1242, Rancho Cucamonga, CA 91730-8133 | 2020-10-23 |
| 1568060499 | Essential Peace of Mind Marriage and Family Therapy, Inc. | Marriage & Family Therapist | 9650 Milliken Ave Apt 4211, Rancho Cucamonga, CA 91730-6073 | 2020-10-13 |
| 1386259422 | Reginald Rogers | Marriage & Family Therapist | 9567 Arrow Rte Ste M, Rancho Cucamonga, CA 91730-4550 | 2020-09-15 |
| 1487275095 | Saving Grace Therapy Services | Marriage & Family Therapist | 8350 Archibald Ave Ste 225, Rancho Cucamonga, CA 91730-3671 | 2020-05-05 |
| 1255967410 | Cadisha Alexa Gravesande | Marriage & Family Therapist | 10532 Acacia St Ste B4, Rancho Cucamonga, CA 91730-5455 | 2020-03-19 |
| 1982235263 | Mel Latone Family Counseling, Inc. | Marriage & Family Therapist | 9033 Base Line Road, Suite M, Rancho Cucamonga, CA 91730 | 2020-01-27 |
| 1699312967 | Richard Guynn King | Marriage & Family Therapist | 9375 Archibald Ave Ste 107, Rancho Cucamonga, CA 91730-5728 | 2019-12-05 |
| 1770126070 | Regina Yvette Famiglietti | Marriage & Family Therapist | 9033 Baseline Rd Ste K, Rancho Cucamonga, CA 91730-1214 | 2019-10-21 |
| 1174081061 | Joe Navarro | Marriage & Family Therapist | 10630 Town Center Dr Ste 102, Rancho Cucamonga, CA 91730-6806 | 2019-03-09 |
| Find all providers in RANCHO CUCAMONGA | ||||
| City | RANCHO CUCAMONGA |
| Zip Code | 91701 |
Please comment or provide details below to improve the information on MR. ANDREW PAUL CLACK.
| 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.