Linnette Ann Clark, PT, PHD

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

9523 Issued in CA

Practice address

4647 Zion Ave
San Diego, CA 92120-2507

Phone

(619) 528-5000

NPI assigned

Oct 20, 2010

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Functionsmart

  • Physical Therapist
  • San Diego, CA
  • NPI 1518132901
  NPD

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1013227289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 INGRAHAM #202",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92109",
            "telephone_number": "925-963-6753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4647 ZION AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921202507",
            "telephone_number": "619-528-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4647 Zion Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921202507",
            "country_code": "US",
            "telephone_number": "619-528-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LINNETTE",
        "middle_name": "ANN",
        "credential": "PT, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "9523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Olaer Clark
• Kathryn M Clark, MPH, RD
• Kayla Clark, PSYD
• Kellie Clark
• Kelsey Elizabeth Clark, MS
• Mary McGinn Clark, PH.D.
• Matthew Clark
• Maximus Clark
• Meghan Clark
• Michael Clark

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.