Andrea R.O. Clark, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY28374 Issued in CA

Practice address

31194 La Baya Dr Ste 100
Westlake Village, CA 91362-6420

Phone

(805) 242-2429

Fax

(310) 870-7197

NPI assigned

Jul 14, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Clinical Psychologist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pacific Coast Psychology Group, Inc.

  • Psychologist
  • Westlake Village, CA
  • NPI 1932647468

  Clinical

  NPD
• Community Health for Asian Americans

  • Community/Behavioral Health Agency
  • Oakland, CA
  • NPI 1437496973
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1013146802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31194 LA BAYA DR STE 100",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913626420",
            "telephone_number": "805-242-2429",
            "fax_number": "310-870-7197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31194 LA BAYA DR STE 100",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913626420",
            "telephone_number": "805-242-2429",
            "fax_number": "310-870-7197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ANDREA",
        "middle_name": "R.O.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY28374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina K Jones MD
• Christine Maria Cicone, PHD
• City Stations, Inc.
• Darren F. Clair, M.D.
• Adam Clark
• Karen Lee Clark, MFT
• Stephen Clark, DPT
• Brenda Joyce Class, M.F.T.
• Clear Ketamine Plus Psychiatry
• Cleverly Inc.

• Clinical Psychologist in Westlake Village, CA
• Providers in Westlake Village, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.