Clark, Molly Patricia

Clark, Molly Patricia is an individual health care provider with primary practice located at 2500 Merced St , San Leandro CA 94577-4201. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Clark, Molly Patricia can be contacted via phone (510) 454-1000.

Contact Information

Primary practice address
2500 Merced St San Leandro CA 94577-4201
Phone: (510) 454-1000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X DI00001478 Washington

Profile Details

NPI number 1508814666
LBN Legal business name Clark, Molly Patricia
Credentials Registered Dietitian (RD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Jan 3rd, 2022 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508814666 NPPES
Washington MEDICAID 8369571
Washington Other 0172923

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