Active NPI
Charae J Clark
- Counselor
- Los Angeles, CA
National Provider Identifier
1972803435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 3761 Stocker St Ste 105
Los Angeles, CA 90008-5129 - Phone
- (323) 294-4261
- Fax
- (323) 294-7261
- NPI assigned
- Oct 29, 2010
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
3761 Stocker St Ste 105
Los Angeles, CA 90008-5129
Mailing address
7833 West Blvd
Inglewood, CA 90305-1228
Phone (323) 294-4261
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288310400000",
"number": "1972803435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7833 WEST BLVD",
"city": "INGLEWOOD",
"state": "CA",
"postal_code": "903051228",
"telephone_number": "323-294-4261",
"fax_number": "323-294-7261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3761 STOCKER ST STE 105",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900085129",
"telephone_number": "323-294-4261",
"fax_number": "323-294-7261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "CHARAE",
"middle_name": "J",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-29",
"last_updated": "2010-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.