Rebecca Marie Clyde, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A71193 Issued in CA

Practice address

2970 Hilltop Mall Rd Ste 304
Richmond, CA 94806-5274

Phone

(510) 204-8090

Fax

(510) 506-7726

NPI assigned

Aug 15, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1184737348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "510-204-8090",
            "fax_number": "510-506-7726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2970 HILLTOP MALL RD STE 304",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948065274",
            "telephone_number": "510-204-8090",
            "fax_number": "510-506-7726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3687 Mt. Diablo Blvd. Suite 200",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "CA",
            "postal_code": "94806",
            "country_code": "US",
            "telephone_number": "510-204-8090",
            "fax_number": "510-506-7726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLYDE",
        "first_name": "REBECCA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2023-03-07",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A71193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "A71193",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Earl Clark II, MD
• Joanna Gwen Clark, P.T.
• Clean Smiles Dental Hygiene Practice of Claire Fleckles and Vicki Harr
• Kasey Clifton
• Sheila E. Clinton, M.S. (ED.), B.S.
• Melisa Coello, ASW
• Annabelle Cole, ACSW
• Damon Ricardo Cole Jr.
• Heather Coleman, PHD
• Zelda Marie Coleman

• Family Medicine Physician in Richmond, CA
• Providers in Richmond, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.