Individual provider · Type 1 NPI

Edward Derby Clark I

Addiction (Substance Use Disorder) Counselor · Sacramento, CA

NPI number 1093028870 Active

Practice location

1355 Pebblewood Dr
Sacramento, CA 95833-1612

Call (916) 289-9380 Map

Fax (916) 441-1758

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1093028870

Edward Derby Clark I's National Provider Identifier is 1093028870, issued on Jul 21, 2010. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Sacramento, CA. The record was last updated on Jun 18, 2015.