Dmitrius Clark
Behavior Technician
3620 W. Hammer Lane
Stockton
, California 95219
Dmitrius Clark
Behavior Technician
3620 W. Hammer Lane
Stockton
, California 95219
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About
Features
Specialties
- Behavior Technician
Languages spoken
- English
Location
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
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FAQs
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Is Dmitrius Clark accepting new patients?
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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)
Provider Location Address
Provider Mailing Address
Entity Type Code
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?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.