Individual
DR. BRIAN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
954 RISA RD, SUITE A, LAFAYETTE, CA 94549-3418
(925) 385-8050
Mailing address
PO BOX 290, ORINDA, CA 94563-0290
(925) 385-8050
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
PSY25198
CA
103TC0700X
Clinical Psychologist
Primary
PSY25198
CA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY25198
CA
103TF0000X
Family Psychologist
PSY25198
CA
Other
Enumeration date
01/15/2007
Last updated
03/30/2013
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