Individual
UMMI CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT, CLC, CSC
Contact information
Practice address
365 W 2ND AVE STE 207, ESCONDIDO, CA 92025-4151
(760) 705-5830
Mailing address
365 W 2ND AVE STE 107, ESCONDIDO, CA 92025-4136
(760) 705-5830
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
41928
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447640289
NPI
CA
Enumeration date
02/02/2015
Last updated
12/18/2023
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