Clark, Kristin Anne

Clark, Kristin Anne is an individual health care provider with primary practice located at 290 Ioof Ave. , Gilroy CA 95020. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Clark, Kristin Anne can be contacted via phone (831) 466-6385.

Contact Information

Primary practice address
290 Ioof Ave. Gilroy CA 95020
Phone: (831) 466-6385
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 73118 California
Behavioral Health & Social Service Providers / Social Worker 104100000X 29221 California
Behavioral Health & Social Service Providers / Clinical 1041C0700X 77878 California

Profile Details

NPI number 1851468052
LBN Legal business name Clark, Kristin Anne
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2006
Last updated Aug 7th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851468052 NPPES
California Other 41807 UNICARE NUMBER

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