Rebecca Sue Clark

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

License

3CD4D24DD7 Issued in CA

Practice address

6530 Wentworth Springs Rd
Georgetown, CA 95634-9701

Phone

(530) 333-8320

NPI assigned

Sep 11, 2026

Last updated

Sep 11, 2026By the provider in NPPES

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)

Not enrolled

Practice roles

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

• Black Oak Mine Unified School District

  • Case Management Agency
  • Georgetown, CA
  • NPI 1043181563
  NPD (past)

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

{
    "created_epoch": "1789084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1114837028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6406 MAIN ST",
            "city": "GEORGETOWN",
            "state": "CA",
            "postal_code": "956349587",
            "telephone_number": "530-333-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6530 WENTWORTH SPRINGS RD",
            "city": "GEORGETOWN",
            "state": "CA",
            "postal_code": "956349701",
            "telephone_number": "530-333-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "REBECCA",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-11",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "CA",
            "license": "3CD4D24DD7",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Black Oak Mine Unified School District
• Black Oak Mine Unified School District
• Debra Boardman-Cheevers, FNP
• James Carley
• Codyanne Marie Coombs, CLT
• Julie Crow-Petersen, NP
• Laura Ann Curry, MA, LMFT
• Gregory L Dales
• Beth A Gerkan, FNP

• Health & Wellness Coach in Georgetown, CA
• Providers in Georgetown, CA by specialty
• Health & Wellness Coach in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; 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.