Nicole Angelynne Rymer Clark, SUDRC

Primary specialty

Day Training/Habilitation SpecialistTaxonomy code 373H00000X

Practice address

4805 Golden Foothill Pkwy
El Dorado Hills, CA 95762-9651

Phone

(530) 644-2412

NPI assigned

Apr 13, 2021

Last updated

Apr 22, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

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.

• Progress House, Inc.

  • Substance Abuse Rehabilitation Facility
  • Garden Valley, CA
  • NPI 1801931878
  NPD (past)

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1487234407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4805 GOLDEN FOOTHILL PKWY",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957629651",
            "telephone_number": "530-644-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 GOLDEN FOOTHILL PKWY",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957629651",
            "telephone_number": "530-644-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYMER CLARK",
        "first_name": "NICOLE",
        "middle_name": "ANGELYNNE",
        "credential": "SUDRC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "11731",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ariela Rozegold, L.AC.
• Naara Yessenia Rubio Martinez
• Kimberly Rudnicki, NP
• Patrick A Rufo, DDS
• Judith Ruiz Novoa
• S. Jang DDS Incorporated (Smile Time Dental)
• S. Van Derwood, Licensed Clinical Social Worker, Inc
• S.Y. Jang DDS Corporatiom (Make A Smile)
• S.Y.Y Jang DDS Corp (Kids Dentist Plus)
• Neil Saboor

• Day Training/Habilitation Specialist in El Dorado Hills, CA
• Providers in El Dorado Hills, CA by specialty
• Day Training/Habilitation Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.