Judy Clark

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

1328 2ND St
Santa Monica, CA 90401-1122

Phone

(310) 394-6889

NPI assigned

Nov 29, 2016

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

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

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1669915369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 2ND ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011122",
            "telephone_number": "310-394-6889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 2ND ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011122",
            "telephone_number": "310-394-6889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JUDY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-29",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clare Matrix
• Clare Matrix
• Elana Marie Clark-Faler, LCSW
• Alan E. Clark, PSY.D.
• Guiselle Clark, M.D.
• Lauren L Clark, DPT
• Sharif Clark, CATC-1 #177290
• Joseph Clarke, LAC
• Murray Clarke, L.AC
• Clavin Labs, Inc.

• All providers in Santa Monica, CA
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; 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.