Individual
MS. ANNIE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3408 ANDOVER ST, OAKLAND, CA 94609-2817
(510) 547-1531
Mailing address
2000 CAMANCHE RD SPC 71, IONE, CA 95640-9428
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/13/2021
Last updated
07/13/2021
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