Active NPI
Gregory Reinaldo Clark, COUNSELOR
- Addiction (Substance Use Disorder) Counselor
- Fresno, CA
National Provider Identifier
1275344764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- R1594550125
- Practice address
- 1235 E St
Fresno, CA 93706-2024 - Phone
- (559) 844-1599
- NPI assigned
- Jan 15, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | R1594550125 | CA | Primary |
Addresses
Primary practice location
1235 E St
Fresno, CA 93706-2024
Mailing address
4183 Finchwood Ave
Clovis, CA 93619-8999
Phone (559) 765-5894
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R1594550125 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736899200000",
"number": "1275344764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4183 FINCHWOOD AVE",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936198999",
"telephone_number": "559-765-5894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1235 E ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937062024",
"telephone_number": "559-844-1599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "GREGORY",
"middle_name": "REINALDO",
"name_prefix": "Mr.",
"credential": "COUNSELOR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-01-15",
"last_updated": "2025-01-15",
"certification_date": "2025-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R1594550125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.