Individual
ADAM G CLARK-TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
21 PENHURST AVE, DALY CITY, CA 94015-4423
(415) 763-7782
Mailing address
21 PENHURST AVE, DALY CITY, CA 94015-4423
(415) 763-7782
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
63563
CA
Other
Enumeration date
09/27/2010
Last updated
10/31/2016
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