Individual
MR. ANDREW J CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1219 OAK KNOLL RD, SANTA MARIA, CA 93455-4303
(805) 268-5218
Mailing address
PO BOX 2531, SANTA MARIA, CA 93457-2531
(805) 268-5218
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LEP3168
CA
101YS0200X
School Counselor
LEP3168
CA
103TS0200X
School Psychologist
LEP3168
CA
Other
Enumeration date
12/02/2011
Last updated
08/14/2019
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