Keith Andrew Clarke, CPT, CMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

67117 Issued in CA

Practice address

3975 5TH Ave
Suite 213
San Diego, CA 92103-3101

Phone

(619) 906-7055

Fax

(619) 639-8269

NPI assigned

Aug 14, 2015

Last updated

Feb 12, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• The Center for Corrective Exercise

  • Chiropractor
  • San Diego, CA
  • NPI 1356714752

  Massage Therapist

  NPD (past) Authorized official

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

{
    "created_epoch": "1439510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1346616208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 W G ST # 819",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921016096",
            "telephone_number": "619-906-7055",
            "fax_number": "619-639-8269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 5TH AVE",
            "address_2": "SUITE 213",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033101",
            "telephone_number": "619-906-7055",
            "fax_number": "619-639-8269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "KEITH",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "CPT, CMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-14",
        "last_updated": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "67117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA MASSAGE THERAPY COUNCIL",
            "identifier": "67117",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1346616208",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aubrey Edward Clarke III, DPT
• Carolyn Clarke, PSYD
• Debbie A Clarke
• Derly Clarke, RD, CDE
• Hannah Clarke
• Keysha Clarke
• Madeline Rae Clarke, RN
• Mary K Clarke, NP
• Megan Eileen Clarke, DDS
• Anne Elizabeth Clarkin, L.C.S.W.

• Massage Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; 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.