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DR. MICHELLE OLIVETTE CLARK M.D. NPI 1164551545


NPI Information

NPI: 1164551545
Provider Name: DR. MICHELLE OLIVETTE CLARK, M.D.
Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Individual

Specialization: Psychiatry

PECOS Registration: Yes

Address:
10921 WILSHIRE BLVD
SUITE 405
LOS ANGELES, CA
ZIP 90024
Phone: (323) 298-1114
Get Directions

DR. Michelle Olivette Clark, M.D. is a psychiatry psychiatry neurology in Los Angeles, CA. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. DR. Michelle Olivette Clark, M.D. NPI is 1164551545. 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:

10921 WILSHIRE BLVD
SUITE 405
LOS ANGELES, CA
ZIP 90024-906
Phone: (323) 298-1114
Fax: (323) 298-1113

The NPI 1164551545 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 3/3/2007 and was last updated on 7/9/2007.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084P0800XPsychiatry & NeurologyPsychiatryA 31665CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1A 26565MEDICARE UPINCALIFORNIA
200A316650MEDICARE PINCALIFORNIA
3A 31665OTHERCALIFORNIASTATE MEDICAL LICENSE

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.