WALTER OTHA CLARK CATC II NPI 1811230980

NPI Information

NPI: 1811230980
Provider Name: WALTER OTHA CLARK, CATC II
Classification: Counselor - 101YA0400X
Specialization: Addiction (Substance Use Disorder)
Entity Type: Individual
Address: 3525 PRESLEY AVE
RIVERSIDE, CA
ZIP 92507
Phone: (951) 782-2400

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NPI Details

Walter Otha Clark, CATC II is an addiction (substance use disorder) counselor in Riverside, CA. Walter Otha Clark, CATC II NPI is 1811230980. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3525 PRESLEY AVE
RIVERSIDE, CA
ZIP 92507-453
Phone: (951) 782-2400

The enumeration date for this NPI number is 3/27/2013 and was last updated on 8/22/2013.

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	101YM0800X	Counselor	Mental Health	3051-I	CALIFORNIA	No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	133051 II	CALIFORNIA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	133051 II	OTHER	CALIFORNIA	CAADE

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: 11/21/2025

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