Individual provider · Type 1 NPI

Glen Antonio Clark Iii

Addiction (Substance Use Disorder) Counselor · San Francisco, CA

NPI number 1952585218 Active

Practice location

1301 Pierce St.
San Francisco, CA 94115

Call (415) 563-8200 Map

Fax (510) 644-2044

Mailing address

1153 Oak St.
San Francisco, CA 94117

Other practice locations

  • 900 Laurel Ave, San Mateo, CA 94401-4211 · (650) 347-8088

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 1952585218

Glen Antonio Clark Iii's National Provider Identifier is 1952585218, issued on Dec 21, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in San Francisco, CA. The record was last updated on Dec 17, 2024.