Paris Clack, PT
Licensed Psychiatric Technician in Roseville, CA. Individual provider (NPI-1).
NPI number1316644792
StatusActive
Last updated in NPPESFeb 15, 2023
Details
- NPI
- 1316644792
- Entity type
- Individual (NPI-1)
- Name
- Paris Clack
- Credential
- PT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 15, 2023
- Certification date
- Feb 15, 2023
- Last updated
- Feb 15, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 167G00000X | Licensed Psychiatric Technician | 42058 | CA | Yes |
Practice location
1133 Coloma Way Ste CRoseville, CA 95661-4480
Phone 916-774-6456
Mailing address
7246 Remmet AveCanoga Park, CA 91303-1531
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All 10 Licensed Psychiatric Technician providers in Roseville · All 6,478 providers in Roseville
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