Ann Marie Monica Clark

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Practice address

3524 Acacia Avenue
San Bernardino, CA 92405

Phone

(909) 352-6701

NPI assigned

Nov 29, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Ann Marie Monica Loring Former name

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": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1962945675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 N. RIVERSIDE AVE",
            "address_2": "#124",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "92376",
            "telephone_number": "909-528-7061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3524 ACACIA AVENUE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92405",
            "telephone_number": "909-352-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ANN MARIE",
        "middle_name": "MONICA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-29",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN MARIE",
            "last_name": "LORING",
            "middle_name": "MONICA",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Citadel Short Term Specialty Treatment Programs
• Citibest Advanced Nursing Services, P.C
• Citibest Healthcare Services LLC (Citibest Home Health Agency)
• Citrus Senior Care
• Clarity Hearing AIDS & Services
• Elizabeth Clark
• Michael Eric Clark, PHARMD
• Pamela Clark
• Quinnita Christine Clark
• Susan Karen Clark

• Assisted Living Facility (Mental Illness) in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Assisted Living Facility (Mental Illness) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; 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.