Individual
ANDREW R CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2400 E 4TH ST, SUITE 100, NATIONAL CITY, CA 91950-2026
(619) 631-0128
(619) 631-0153
Mailing address
PO BOX 511347, SUITE 100, LOS ANGELES, CA 90051-7902
(619) 631-0128
(619) 631-0153
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY10061
CA
Other
Enumeration date
06/12/2006
Last updated
03/28/2017
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