Provider Demographics
NPI:1467678300
Name:CLARK, PILAR MARIE (ASW)
Entity Type:Individual
Prefix:MRS
First Name:PILAR
Middle Name:MARIE
Last Name:CLARK
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 EUCLID AVE
Mailing Address - Street 2:SUITE #103
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-2931
Mailing Address - Country:US
Mailing Address - Phone:619-267-5115
Mailing Address - Fax:619-267-4657
Practice Address - Street 1:502 EUCLID AVE
Practice Address - Street 2:SUITE #103
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2931
Practice Address - Country:US
Practice Address - Phone:619-267-5115
Practice Address - Fax:619-267-4657
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW164911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical