Janelle Clark

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

30993 Issued in CA

Practice address

686 W Line St
Bishop, CA 93514-3315

Phone

(805) 570-9375

NPI assigned

Mar 26, 2007

Sex

Female

Sole proprietor

Yes

Specialty

Clinical Psychologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 21, 2024.

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713657600000",
    "number": "1750409249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 823",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935150823",
            "telephone_number": "805-570-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "686 W LINE ST",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935143315",
            "telephone_number": "805-570-9375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 Sierra Park Rd",
            "address_purpose": "LOCATION",
            "city": "Mammoth Lakes",
            "state": "CA",
            "postal_code": "935462073",
            "country_code": "US",
            "telephone_number": "760-924-4333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JANELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2024-04-21",
        "certification_date": "2024-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "52043",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "30993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremiah Cheng
• Linda M Christensen, LCSW
• Kathleen Citrenbaum, LCSW
• City of Bishop
• Dolphe Scott Clark, M.D.
• John Clark, RN
• Savannah Faye Cole, LMFT
• Connie Lou Connolly, R.N.
• Grace Cook, PH.D., M.F. T.
• Yolanda Cortez

• All providers in Bishop, CA
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.