Individual provider Active NPI

Janet Loraine Clark, LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1316196223
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
101036 Issued in CA
Practice address
10815 Rancho Bernardo Rd Ste 380
San Diego, CA 92127-5724
Phone
(858) 279-1223
NPI assigned
Sep 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 101036 CA Primary

Addresses

Primary practice location

10815 Rancho Bernardo Rd Ste 380
San Diego, CA 92127-5724

Mailing address

10815 Rancho Bernardo Rd Ste 380
San Diego, CA 92127-5724

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240801004041 CA Practitioner - Marriage and Family Therapist 2365989894 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101036CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Psycare Inc PastSince Jun 19, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: psycareassociates.janetclark@143255.advancedmd-direct.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1316196223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10815 RANCHO BERNARDO RD STE 380",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10815 RANCHO BERNARDO RD STE 380",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275724",
            "telephone_number": "858-279-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JANET",
        "middle_name": "LORAINE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-16",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "101036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.