Khristian Clark, is a
Rehabilitation Practitioner based in Escondido, California. Khristian Clark is licensed to practice in * (Not Available) (license number ) and her current practice location is
25143 Jack Rabbit Acres, Escondido, California. She can be reached at her office (for appointments etc.) via phone at
(760) 566-8648.
NPI number for Khristian Clark is 1851055792 and her current mailing address is 1738 S Tremont St, Oceanside, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1851055792.
Healthcare Provider's Profile
| Full Name | Khristian Clark |
|---|
| Gender | Female |
|---|
| Speciality | Rehabilitation Practitioner |
|---|
| Location | 25143 Jack Rabbit Acres, Escondido, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1851055792
- Provider Enumeration Date: 10/27/2021
- Last Update Date: 02/14/2024
Medical Identifiers
Medical identifiers for Khristian Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1851055792 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
| 225400000X | Rehabilitation Practitioner | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Khristian Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Khristian Clark,
1738 S Tremont St,
Oceanside, CA 92054-5309
Ph: (760) 439-2800 | Khristian Clark,
25143 Jack Rabbit Acres,
Escondido, CA 92026-1267
Ph: (760) 566-8648 |
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