Summer Renee Clark, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW69801 Issued in CA

Practice address

4400 Olds Rd
Oxnard, CA 93033-8061

Phone

(805) 673-3930

Fax

(805) 659-3217

NPI assigned

Sep 18, 2016

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

State licenses

Practice roles

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.

• Clinicas del Camino Real Inc

  dba Clinicas del Camino Real, Inc., Paseo Camarillo

  • Federally Qualified Health Center (FQHC)
  • Camarillo, CA
  • NPI 1295297190
  NPD (past)
• Clinicas del Camino Real Inc

  dba Clinicas del Camino Real, Inc., La Colonia

  • Federally Qualified Health Center (FQHC)
  • Oxnard, CA
  • NPI 1942789359
  NPD (past)

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

{
    "created_epoch": "1474156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492128000000",
    "number": "1114475233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 FLYNN RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125092",
            "telephone_number": "805-673-3930",
            "fax_number": "805-659-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 OLDS RD",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930338061",
            "telephone_number": "805-673-3930",
            "fax_number": "805-659-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SUMMER",
        "middle_name": "RENEE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-18",
        "last_updated": "2017-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW69801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City Impact
• City Impact, Inc
• City of Oxnard
• Jaelyn Clark
• Karalee J Clark
• William James Clark, DDS, MD
• Clarknet Inc.
• Jessa Claudio
• Dorothea Clayton, M.D.
• Clear Line Logistics

• Clinical Social Worker in Oxnard, CA
• Providers in Oxnard, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2017; 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.