Active NPI
Marianne Clark
- Marriage & Family Therapist
- San Leandro, CA
National Provider Identifier
1356899439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 96578
- Practice address
- 2275 Arlington Dr
San Leandro, CA 94578-1132 - Phone
- (510) 317-1444
- NPI assigned
- Sep 16, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Mental Health Counselor | 101YM0800X | 96578 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 96578 | CA | |
| Marriage & Family Therapist | 106H00000X | 96578 | CA | Primary |
Addresses
Primary practice location
2275 Arlington Dr
San Leandro, CA 94578-1132
Mailing address
1530 Dolores St Apt 4
San Francisco, CA 94110-4901
Phone (415) 404-5335
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Counselor | Current | Accepting new patients |
Interoperability endpoints
- marianneclark@tdh.allscriptsdirect.net
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Lewisville, TX
- NPI 1245403567
Counselor
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646611200000",
"number": "1356899439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1530 DOLORES ST APT 4",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941104901",
"telephone_number": "415-404-5335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2275 ARLINGTON DR",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945781132",
"telephone_number": "510-317-1444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "MARIANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-16",
"last_updated": "2022-03-07",
"certification_date": "2022-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "96578",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "96578",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "96578",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.