Joeanna Clark

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-21-500028 Issued in CA

Practice address

333 University Ave Ste 200
Sacramento, CA 95825-6540

Phone

(855) 832-6727

Fax

(772) 675-9100

NPI assigned

Aug 14, 2018

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1992285506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7108 S KANNER HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349977462",
            "telephone_number": "855-832-6727",
            "fax_number": "772-675-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 UNIVERSITY AVE STE 200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958256540",
            "telephone_number": "855-832-6727",
            "fax_number": "772-675-9100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 University Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "95825",
            "country_code": "US",
            "telephone_number": "855-832-6727",
            "fax_number": "772-675-9100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2150 River Plaza Dr Ste 410",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958334140",
            "country_code": "US",
            "telephone_number": "866-727-8274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JOEANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-14",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "RBT-16-26486",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-21-500028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fred Allen Clark, PHD, LMFT
• Isaiah James Clark, MD
• James Russell Clark, CADCA
• Jessica Lynne Clark, LCSW
• Jill Jeffers Clark, MA, PHD
• Julie Alysia Clark, RADT
• Kacee Lynn Clark
• Kaylyn Clark
• Kyle Clark
• Larry Dean Clark III

• Behavior Analyst in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.