Individual
CAMERON CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1931 CENTER ST, BERKELEY, CA 94704-1105
(510) 666-9552
Mailing address
1087 STANFORD AVE APT C, OAKLAND, CA 94608-2358
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
I8222069
CA
Other
Enumeration date
04/04/2011
Last updated
04/04/2011
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