Alexandra Elyse Clark
Social Worker in Fountain Valley, CA. Individual provider (NPI-1).
NPI number1386155182
StatusActive
Last updated in NPPESNov 28, 2023
Details
- NPI
- 1386155182
- Entity type
- Individual (NPI-1)
- Name
- Alexandra Elyse Clark
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 19, 2017
- Certification date
- Nov 28, 2023
- Last updated
- Nov 28, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 104100000X | Social Worker | 117235 | CA | Yes |
Practice location
16580 Harbor Blvd Ste OFountain Valley, CA 92708-1396
Phone 714-788-6165
Mailing address
16580 Harbor Blvd Ste OFountain Valley, CA 92708-1396
Phone 714-788-6165
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 31 Social Worker providers in Fountain Valley · All 3,097 providers in Fountain Valley
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