CAROLYN CLARK AC-CRNP-PMH NPI 1124429857

NPI Information

  • NPI: 1124429857
  • Provider Name: CAROLYN CLARK, AC-CRNP-PMH
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 6010 HIDDEN VALLEY RD STE 115
    CARLSBAD, CA
    ZIP 92011
  • Phone: (760) 797-8494

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NPI Details

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
1363LP0808XNurse PractitionerPsychiatric/Mental HealthAC001401MARYLANDNo
2363LP0808XNurse PractitionerPsychiatric/Mental HealthNP95013648CALIFORNIAYes

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: 3/30/2025

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