Latrisha Clark

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

212 I St
Davis, CA 95616-4213

Phone

(530) 601-5959

Fax

(916) 287-4679

NPI assigned

Jan 19, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1295395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1841595055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8912 VOLUNTEER LN",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958263221",
            "telephone_number": "916-344-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 I ST",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956164213",
            "telephone_number": "530-601-5959",
            "fax_number": "916-287-4679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6833 Stockton Blvd",
            "address_2": "#485",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958232372",
            "country_code": "US",
            "telephone_number": "916-394-0800 x152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LATRISHA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-19",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Joseph Chulak
• Karen Chung, MD
• Michael Ciccarelli
• Dena Anne Cissna, IBCLC
• Cheryll Anne Clark, M.D.
• Michele Lynn Clark
• Jennifer P. Clary, MD
• Patricia Claxton
• Kenneth C Clay, MD
• Clear Blue Nutrition Inc

• Mental Health Counselor in Davis, CA
• Providers in Davis, 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 Jan 6, 2022; 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.