Jessica Rain Clark, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC 44628 Issued in CA

Practice address

655 Oak Grove Ave Unit 170
Menlo Park, CA 94026-5002

Phone

(650) 275-4880

NPI assigned

Aug 5, 2007

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1396936688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 OAK GROVE AVE UNIT 170",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940265002",
            "telephone_number": "650-275-4880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 OAK GROVE AVE UNIT 170",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940265002",
            "telephone_number": "650-275-4880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "290 Ioof Ave",
            "address_purpose": "LOCATION",
            "city": "Gilroy",
            "state": "CA",
            "postal_code": "950205204",
            "country_code": "US",
            "telephone_number": "650-275-4880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JESSICA",
        "middle_name": "RAIN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 44628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riley Chycota
• Katarzyna M Ciesielski, MD
• Linda Cintron, MD
• James A Cisco, MD
• Isha A Clark, M.D.
• Edgar Neil Infante Claveria Jr., P.T.
• Shawndell Kalisha Clay, PSY.D.
• Karli Erin Cleary, DO
• Molly Cluff, OTR
• Gerald Cohen, D.C.

• Marriage & Family Therapist in Menlo Park, CA
• Providers in Menlo Park, 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 Mar 25, 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.

Verify at the official NPI Registry.