NPIMap

Organization Active NPI

Restoring Family Harmony

  • Clinical Psychologist
  • Sacramento, CA
National Provider Identifier
1073828273
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 20715 Issued in CA
Legal business name
RESTORING FAMILY HARMONY
Practice address
874 57TH St
Sacramento, CA 95819-3327
Phone
(916) 739-1926
Fax
(916) 739-1591
NPI assigned
Aug 11, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

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

Authorized official

Name
Dr. Jill Jeffers Clark, PHD.NPI 1447375563
Title
Clinical Psychologist
Phone
(916) 739-1926

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X PSY 20715 CA
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X PSY 20715 CA Primary
Family PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TF0000X PSY 20715 CA
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X LCS 24412 CA
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X MFC 36061 CA

Addresses

Primary practice location

874 57TH St
Sacramento, CA 95819-3327

Mailing address

874 57TH St
Sacramento, CA 95819-3327
Phone (916) 739-1926

Other identifiers 1

IdentifierTypeStateIssuer
CN319AOtherCAMEDICARE PTAN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281484800000",
    "number": "1073828273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 57TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193327",
            "telephone_number": "916-739-1926",
            "fax_number": "916-739-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 57TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193327",
            "telephone_number": "916-739-1926",
            "fax_number": "916-739-1591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORING FAMILY HARMONY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-11",
        "last_updated": "2010-08-11",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "JEFFERS",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "916-739-1926",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 20715",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 20715",
            "primary": true
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Family",
            "state": "CA",
            "license": "PSY 20715",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 24412",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 36061",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CN319A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; 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.