Individual provider · NPI-1

Janelle Clark

Psychologist, Clinical · Bishop, CA

NPI number1750409249
StatusActive
Last updated in NPPESApr 21, 2024

Details

NPI
1750409249
Entity type
Individual (NPI-1)
Name
Janelle Clark
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 26, 2007
Certification date
Apr 21, 2024
Last updated
Apr 21, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103TC0700X Psychologist, Clinical30993CAYes
106H00000X Marriage & Family Therapist52043CA

Practice location

686 W Line St
Bishop, CA 93514-3315

Phone 805-570-9375

Mailing address

Po Box 823
Bishop, CA 93515-0823

Phone 805-570-3750

Other practice locations

85 Sierra Park Rd
Mammoth Lakes, CA 93546-2073

Phone 760-924-4333

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