Provider Demographics
NPI:1215567268
Name:CLARKE PSYCHOTHERAPY INC
Entity Type:Organization
Organization Name:CLARKE PSYCHOTHERAPY INC
Other - Org Name:CLARKE PSYCHOTHERAPY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NISHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT
Authorized Official - Phone:951-252-6083
Mailing Address - Street 1:PO BOX 696
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92586-0696
Mailing Address - Country:US
Mailing Address - Phone:951-252-6083
Mailing Address - Fax:951-800-8164
Practice Address - Street 1:29995 TECHNOLOGY DR STE 103
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2633
Practice Address - Country:US
Practice Address - Phone:951-378-5233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLARKE PSYCHOTHERAPY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-17
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty