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Dmitrius Clark

Behavior Technician

3620 W. Hammer Lane
Stockton , California 95219

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Dmitrius Clark

Behavior Technician

3620 W. Hammer Lane
Stockton , California 95219

Write a Review Save Call

Dmitrius Clark

Behavior Technician

3620 W. Hammer Lane
Stockton , California 95219

Write a Review Save

About


Features

Language(s) Spoken
English
Ethnic Identity
White / Caucasian

Specialties

  • Behavior Technician

Languages spoken

  • English

Location

3620 W. Hammer Lane Stockton , California 95219

First Address

  • Dmitrius Clark
  • 3425 Coffee Rd Suite C2
  • Modesto, CA
  • Zip : 95355
  • Phone :

Second Address

  • Dmitrius Clark
  • 3620 W. Hammer Lane
  • Stockton, CA
  • Zip : 95219
  • Phone : (209) 521-4791

Reviews

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FAQs


Where did Dmitrius Clark attend graduate school?

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Where did Dmitrius Clark do his residency?

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Where did Dmitrius Clark do his fellowship?

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Is Dmitrius Clark board certified?

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What type of doctor is Dmitrius Clark

Behavior Technician

In what state does Dmitrius Clark practice in?

California

Where is Dmitrius Clark ’s practice located?

3620 W. Hammer Lane , Stockton, California, 95219

What is Dmitrius Clark ’s gender?

Male

Is Dmitrius Clark a sole practitioner?

No

Is Dmitrius Clark accepting new patients?

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What languages does Dmitrius Clark speak?

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Does Dmitrius Clark accept insurance?

Yes, Dmitrius Clark accepts insurance

Does Dmitrius Clark offers telemedicine?

Dmitrius Clark has not indicated if he offers telemedicine

What is Dmitrius Clark ’s professional license number?

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What is Dmitrius Clark ’s NPI number?

1003386657

Does Dmitrius Clark have any license restrictions?

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Scope of Practice

Primary Taxonomy Code Taxonomy Specialty License Number License State
Y 106S00000X Behavior Technician

National Provider Identifier

NPI 1003386657
Provider Name Dmitrius Clark
First Address Modesto, CA 95355
Second Address Stockton, CA 95219
Gender M
NPI Entity type Individual
Is Sole Proprietor No
Is Organization Subpart N/A
Enumeration Date 27/11/2018
Last Update Date 27/11/2018

NPI Footnotes


What is the National Provider Identifier (NPI)

The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address

The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address

The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code

The code describing the type of health care provider that is being assigned an NPI. The entity type codes are:
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?

Subparts are the components and separate physical locations of organization health care providers. Subpart examples include: Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name

The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.

Provider Enumeration Date

The date the provider was assigned a unique identifier (assigned an NPI)

Last Update Date

The date that a NPI record was last updated or changed

Primary Taxonomy Code

The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPls the license data is associated to the taxonomy code.

Authorized Official Name

The name of the person authorized to submit the PI application or to officially change data for a health care provider.

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