Agape Clinic With Heart: a Professional Nursing Organization

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

AGAPE CLINIC WITH HEART: A PROFESSIONAL NURSING ORGANIZATION

Practice address

3114 Carvel Dr
Santa Rosa, CA 95405-7062

Phone

(707) 757-3117

NPI assigned

May 8, 2025

Last updated

May 8, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennifer Marie Clark, FNP-BC, PMHNP-BCNPI 1437335551

Title

Nurse Practitioner, President

Phone

(707) 757-3117

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer M. Clark, R.N., FNP, PMHNP

  • Nurse Practitioner
  • Santa Rosa, CA
  • NPI 1437335551
  NPD Authorized official

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

{
    "created_epoch": "1746662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746662400000",
    "number": "1821888249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3114 CARVEL DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057062",
            "telephone_number": "707-757-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3114 CARVEL DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057062",
            "telephone_number": "707-757-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE CLINIC WITH HEART: A PROFESSIONAL NURSING ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-08",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER, PRESIDENT",
        "authorized_official_telephone_number": "707-757-3117",
        "authorized_official_credential": "FNP-BC, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arianne Renee Advocate, MA, MFTI
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• Tina Page Afifi, HA7576
• Jamie Dawn Agapoff, M.D.
• Anu Agarwal, M.D.
• Maryam Aghighi, MD
• Johnathan Emad Agil, MD
• Aging Solutions of Sonoma County LLC (Home Instead)

• Adult Mental Health Clinic/Center in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Adult Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; 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.