Victoria Lynn Clark, LCSW
Individual provider Active NPI Clinical Social Worker · Cameron Park, CA
NPI 1700201506 · NPPES record last updated Dec 2, 2024
Key facts
- NPI
- 1700201506
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 122437 (CA)
- Practice address
- 3430 Robin LN
Cameron Park, CA 95682-8407 - Phone
- (530) 227-6495
- NPI assigned
- Mar 3, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241213003409 | CA | Practitioner - Clinical Social Worker | 5294261293 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PC | Mental Health | Current |
Accepting new patients |
| Creative Counseling | Past | Accepting new patients |
Locations
99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 122437 | CA | Yes |
Addresses
Primary practice location
3430 Robin LN
Cameron Park, CA 95682-8407
Mailing address
3224 Heights Dr
Cameron Park, CA 95682-8543
Phone (530) 227-6495
Other practice location 1
3224 Heights Dr., Cameron Park, CA 95682
3224 Heights Dr.
Cameron Park, CA 95682
Phone (530) 295-1491
Other providers in Cameron Park, CA
- Helen Yen-Hwa Cheng
- Wai Kan Chiu
- Lauren Chong
- CHW Medical Foundation
- CHW Medical Foundation
- Marissa Cochran
- Matthew Stephen Cole
- Anndrea Hope Collins
- Comprehensive Orthopedic Rehabilitation and Exercise Physical Therapy
- Brian Barrington Cook
All providers in Cameron Park, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.