Active NPI
Samantha Jeanine Clark, MS, COUNSELING PSYCH
- Marriage & Family Therapist
- Bakersfield, CA
National Provider Identifier
1871154443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 999031549
- Practice address
- 2621 Oswell St Ste 119
Bakersfield, CA 93306-3172 - Phone
- (661) 868-6750
- NPI assigned
- Jun 25, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 999031549 | CA | Primary |
Addresses
Primary practice location
2621 Oswell St Ste 119
Bakersfield, CA 93306-3172
Mailing address
2621 Oswell St Ste 119
Bakersfield, CA 93306-3172
Phone (661) 868-6750
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 999031549 | Other | CA | KERN BEHAVIORAL HEALTH AND RECOVERY SERVICES |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | sclark@kernbhrs.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 999031549 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597276800000",
"number": "1871154443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2621 OSWELL ST STE 119",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933063172",
"telephone_number": "661-868-6750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2621 OSWELL ST STE 119",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933063172",
"telephone_number": "661-868-6750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "SAMANTHA",
"middle_name": "JEANINE",
"name_prefix": "Miss",
"credential": "MS, COUNSELING PSYCH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-25",
"last_updated": "2020-08-13",
"certification_date": "2020-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "999031549",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KERN BEHAVIORAL HEALTH AND RECOVERY SERVICES",
"identifier": "999031549",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "sclark@kernbhrs.org",
"affiliation": "N",
"endpointDescription": "work email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "email",
"address_1": "2621 Oswell St Ste 119",
"city": "Bakersfield",
"state": "CA",
"country_code": "US",
"postal_code": "933063172",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.