Nikki Clark

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2535 Kettner Blvd
1A4
San Diego, CA 92101-1250

Phone

(619) 615-0701

NPI assigned

Oct 10, 2012

Sex

Female

Sole proprietor

No

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": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349827200000",
    "number": "1750633046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4667 60TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921153825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 KETTNER BLVD",
            "address_2": "1A4",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921011250",
            "telephone_number": "619-615-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "NIKKI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-10",
        "last_updated": "2012-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan Clark
• Michael Clark
• Michelle Alicia Clark
• Mitchell Brady Clark, M.S.
• Neal D Clark
• Paris Dawn Clark, DACM, CMT
• Patricia Chu Clark, M.D.
• Patrick Andrew Clark
• Paul Ray Clark, M.D.
• Paula K Clark, MA

• Mental Health Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; 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.