CAROLYN CLARK AC-CRNP-PMH NPI 1124429857

NPI Information

NPI: 1124429857
Provider Name: CAROLYN CLARK, AC-CRNP-PMH
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
6010 HIDDEN VALLEY RD STE 115
CARLSBAD, CA
ZIP 92011
Phone: (760) 797-8494
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Carolyn Clark, AC-CRNP-PMH is a psychiatric/mental health nurse practitioner in Carlsbad, CA. Carolyn Clark, AC-CRNP-PMH NPI is 1124429857. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

6010 HIDDEN VALLEY RD STE 115
CARLSBAD, CA
ZIP 92011-219
Phone: (760) 797-8494

The NPI 1124429857 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/12/2014 and was last updated on 9/3/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	AC001401	MARYLAND	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	NP95013648	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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