Individual
SHAYNA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 268-2900
Mailing address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 268-2900
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT36132
CA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/11/2011
Last updated
11/30/2011
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