Organization Active NPI

Deierhoi-Clark Psychology, a Professional Organization

  • Adult Mental Health Clinic/Center
  • San Diego, CA
National Provider Identifier
1306534219
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
DEIERHOI-CLARK PSYCHOLOGY, A PROFESSIONAL ORGANIZATION
Practice address
2535 Kettner Blvd Ste 2B1
San Diego, CA 92101-1253
Phone
(619) 512-9451
Fax
(619) 821-9721
NPI assigned
Apr 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Clarie Emily Deierhoi-Clark, PHDNPI 1083015333
Title
Owner/Psychologist
Phone
(619) 512-9451

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

2535 Kettner Blvd Ste 2B1
San Diego, CA 92101-1253

Mailing address

2535 Kettner Blvd Ste 2B1
San Diego, CA 92101-1253
Phone (619) 512-9451

Other names 1

  • clarie deierhoiclark phd Other name

National Provider Directory

National Provider Directory

Locations

2535 Kettner Blvd
Ste 2B1
San Diego, CA 92101
Phone (619) 308-6424

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1682553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1306534219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 KETTNER BLVD STE 2B1",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921011253",
            "telephone_number": "619-512-9451",
            "fax_number": "619-821-9721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 KETTNER BLVD STE 2B1",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921011253",
            "telephone_number": "619-512-9451",
            "fax_number": "619-821-9721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEIERHOI-CLARK PSYCHOLOGY, A PROFESSIONAL ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-27",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "DEIERHOI-CLARK",
        "authorized_official_first_name": "CLARIE",
        "authorized_official_middle_name": "EMILY",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "619-512-9451",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "clarie deierhoiclark phd",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.