Individual provider · Type 1 NPI

Jack Clark

Addiction (Substance Use Disorder) Counselor · Fresno, CA

NPI number 1477799112 Active

Practice location

4411 N Cedar Ave
Fresno, CA 93726-2538

Call (559) 248-1548 Map

Fax (229) 248-1530

Mailing address

830 West Ave
Sanger, CA 93657-2849

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 1477799112

Jack Clark's National Provider Identifier is 1477799112, issued on Dec 31, 2008. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Fresno, CA. The record was last updated on Dec 31, 2008.