Lisa Clark

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

845 E Arrow Hwy
Pomona, CA 91767-2535

Phone

(909) 624-1233

Fax

(909) 624-1375

NPI assigned

Jan 3, 2018

Sex

Female

Sole proprietor

No

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, last updated by the provider on Jan 3, 2018.

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1780191445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 E ARROW HWY",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672535",
            "telephone_number": "909-624-1233",
            "fax_number": "909-624-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 E ARROW HWY",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672535",
            "telephone_number": "909-624-1233",
            "fax_number": "909-624-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LISA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-03",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Joseph Clabaugh, SUDCC#7266
• Claremont Community Care Clinic
• Claremont Foothills Health Associates LLC
• Claremont Imaging Associates, a Medical Corporation
• Caroline Clark, BT
• Reagan Clark, AA
• Sir Clark
• Michelle Marie Claustro
• Lance R. Clawson, C.P.O.
• Kristin Clayton, OTR/L

• All providers in Pomona, CA
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2018; 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.