Heather Marie Dubbert Clark, MA, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

125235 Issued in CA

Practice address

732 S Catalina Ave
Redondo Beach, CA 90277-4611

Phone

(310) 877-0775

NPI assigned

Apr 4, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1617494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617494400000",
    "number": "1336728757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 AVENUE I",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775617",
            "telephone_number": "310-316-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 S CATALINA AVE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902774611",
            "telephone_number": "310-877-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "HEATHER",
        "middle_name": "MARIE DUBBERT",
        "name_prefix": "Ms.",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-04",
        "last_updated": "2021-04-04",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "125235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Cipiti, PHARMD
• Gary Alan Citron, PH.D.
• City of Redondo Beach
• Ann M Clark, O.D.
• Catalina Francesca Betty Clark, LM, CPM
• Nathan Clark, DC
• Tyler Keith Clark, D.C.
• Anne Louise Clary, MFT
• Clear Recovery Center, LLC
• Clear Recovery Center, LLC

• Marriage & Family Therapist in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.