MRS. KIMBERLY IRENE CLARK (NPI# 1609050913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609050913 |
| Entity Type | Individual |
| Full Name | MRS. KIMBERLY IRENE CLARK |
| Credential | MFT |
| Practice Address |
3077 Coolidge Ave Costa Mesa CA 92626-2809 |
| Practice Telephone | 7146147382 |
| Practice Fax Number | 7144440722 |
| Mailing Telephone | 7146147382 |
| Mailing Fax Number | 7144440722 |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2007-12-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
40815 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902362452 | Kimberly Michelle Clark | Technician, Other | 2819 Se Brodiaea Ct, Hillsboro, OR 97123-5201 | 2019-02-20 |
| 1780037994 | Kimberly Clark | Nurse Practitioner | 11251 Westwood Ave, Denham Springs, LA 70726-6947 | 2016-07-22 |
| 1053651869 | Kimberly Gail Clark | Hearing Instrument Specialist | 401 Apperson Dr, Salem, VA 24153-7026 | 2013-02-15 |
| 1952660524 | Kimberly Jo Clark | Licensed Practical Nurse | 334 Elmwood Ave, Barberton, OH 44203-1153 | 2012-05-16 |
| 1336421999 | Kimberly D Clark | Speech-Language Pathologist | 1524 Lexington Road, Clovis, NM 88101-6846 | 2011-09-09 |
| 1376878595 | Kimberly Clark | Physical Therapist | 101 S Kraemer Blvd Ste 125, Placentia, CA 92870-6100 | 2009-10-06 |
| 1053591875 | Kimberly Ann Clark | Counselor | 1516 S Boston Ave, Suite 100, Tulsa, OK 74119-4003 | 2007-11-08 |
| 1841400868 | Kimberly Clark | Social Worker | 4350 Woodland Ave, Jackson, MS 39206-3955 | 2007-05-22 |
| 1902900293 | Kimberly A Clark | Physical Therapist | 614 Monkton Rd, Bristol, VT 05443-5392 | 2006-09-08 |
| 1114996931 | Kimberly Sue Clark | Licensed Practical Nurse | 4563 S Ridge Rd E, Geneva, OH 44041-7310 | 2006-03-15 |
| Street Address |
3077 COOLIDGE AVE |
| City | COSTA MESA |
| State | CA |
| Zip Code | 92626-2809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536982 | Sergio Gutierrez | Behavior Technician | 3303 Harbor Blvd., Suite B8, Costa Mesa, CA 92626 | 2020-10-22 |
| 1780201848 | Kelly Chauvet | Behavior Technician | 1503 Nutmeg Place Suite 110, Costa Mesa, CA 92626 | 2020-07-06 |
| 1316564610 | Timo Rosa | Behavior Technician | 1503 Nutmeg Place, Suite 110, Costa Mesa, CA 92626 | 2020-07-02 |
| 1255966115 | Dalia A Sehweil | Behavior Technician | 1111 Baker, Costa Mesa, CA 92626 | 2020-03-11 |
| 1265071096 | Austin Stotelmyre | Behavior Technician | 1111 Baker St Costa Mesa 92626, Costa Mesa, CA 92626 | 2019-12-26 |
| 1396383022 | The Open Table | Community/Behavioral Health | 151 Kalmus Dr. Bldg C, Suite 100, Costa Mesa, CA 92626 | 2019-12-12 |
| 1851933550 | Jennifer Rivera | Behavior Technician | 1111 Baker St. Unit #a, Costa Mesa, CA 92626 | 2019-10-14 |
| 1962053595 | Peter Na | Behavior Technician | Behavior Functions 3303 Harbor Blvd, Ste B8, Costa Mesa, CA 92626 | 2019-09-25 |
| 1346897147 | Jennifer Lopez | Behavior Technician | 555 Alton Blvd Suite 150, Costa Mesa, CA 92626 | 2019-08-26 |
| 1679134084 | Danny Garcia Chiropractic, PC | Chiropractor | 1503 South Coast Drive, Suite 319, Costa Mesa, CA 92626 | 2019-06-26 |
| Find all providers in zip 92626 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902457260 | Kathrin Winkler Therapy, LLC | Counselor | 2900 Bristol St Ste J206, Costa Mesa, CA 92626-7921 | 2019-09-26 |
| 1780141820 | Richard Mendoza | Counselor | 3187 Airway Ave Ste A, Costa Mesa, CA 92626-4603 | 2019-02-25 |
| 1386112647 | Alta Connect Carellc | Counselor | 2900 Bristol St # 206, Costa Mesa, CA 92626-5981 | 2018-11-05 |
| 1467927681 | Brandi Lynn Martin | Counselor | 2790 Harbor Blvd Ste 310, Costa Mesa, CA 92626-5157 | 2018-10-04 |
| 1427566561 | Kara Lynn Scartaccini | Counselor | 308 Santo Tomas Ave, Costa Mesa, CA 92627-4655 | 2018-01-10 |
| 1982114146 | Venus Bulandus | Counselor | 985 Victoria St, Costa Mesa, CA 92627-4067 | 2017-10-02 |
| 1346759396 | Bethany Marie Lesh | Counselor | 275 Baker St, Costa Mesa, CA 92626-4566 | 2017-09-21 |
| 1184175507 | Alfredo Arciniega | Counselor | 3400 Avenue of The Arts Apt G113, Costa Mesa, CA 92626-7177 | 2016-10-20 |
| 1255886438 | Jason Gerry | Counselor | 594 Wendy Ln, Costa Mesa, CA 92627-5515 | 2016-08-17 |
| 1588021141 | Karla R Martinez | Counselor | 151 Kalmus Dr Ste 145, Costa Mesa, CA 92626-5988 | 2016-01-26 |
| Find all providers in COSTA MESA | ||||
| City | COSTA MESA |
| Zip Code | 92626 |
Please comment or provide details below to improve the information on MRS. KIMBERLY IRENE 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.