Julie Alysia Clark, RADT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1322980918 Issued in CA

Practice address

310 Harris Ave Ste a
Sacramento, CA 95838-3249

Phone

(916) 649-6793

Fax

(916) 929-7411

NPI assigned

Oct 5, 2018

Last updated

Mar 24, 2022By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Volunteers of America Northern California & Northern Nevada

  dba Options for Recovery

  • Substance Abuse Rehabilitation Facility
  • Oakland, CA
  • NPI 1215064100
  NPD (past)

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

{
    "created_epoch": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1215402284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 GRAND AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958383512",
            "telephone_number": "916-929-1951",
            "fax_number": "916-929-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 HARRIS AVE STE A",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958383249",
            "telephone_number": "916-649-6793",
            "fax_number": "916-929-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JULIE",
        "middle_name": "ALYSIA",
        "credential": "RADT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-05",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1322980918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCAPP",
            "identifier": "R1322980918",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Isaiah James Clark, MD
• James Russell Clark, CADCA
• Jessica Lynne Clark, LCSW
• Jill Jeffers Clark, MA, PHD
• Joeanna Clark
• Kacee Lynn Clark
• Kaylyn Clark
• Kyle Clark
• Larry Dean Clark III
• Lauren Clark

• Addiction (Substance Use Disorder) Counselor in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; 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.