Clark, Joy Jean
Clark, Joy Jean is an sole proprietor health care provider with primary practice located at 120 E. Kimball Avenue Suite 2, Hemet CA 92543. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Clark, Joy Jean can be contacted via phone (951) 392-3219.Contact Information
Primary practice address
120 E. Kimball Avenue Suite 2
Hemet CA 92543
Phone: (951) 392-3219
Fax: (951) 392-3087
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY11556 | California |
Behavioral Health & Social Service Providers / Forensic | 103TF0200X | PSY11556 | California |
Profile Details
NPI number | 1538253174 |
---|---|
LBN Legal business name | Clark, Joy Jean |
Credentials | PH.D. |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Oct 3rd, 2006 |
Last updated | Nov 29th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1538253174 | NPPES |
Other | 0PL115560 | MEDICARE ID | |
Other | PSY11556 | MEDICARE ID | |
MEDICAID | PSY115560 | MEDICARE ID |
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