Provider Demographics
NPI:1336248988
Name:CLARKE, WHITNEY GOODRICH (PSYD)
Entity Type:Individual
Prefix:MR
First Name:WHITNEY
Middle Name:GOODRICH
Last Name:CLARKE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2019 WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2329
Mailing Address - Country:US
Mailing Address - Phone:415-420-7431
Mailing Address - Fax:415-447-8665
Practice Address - Street 1:2019 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2329
Practice Address - Country:US
Practice Address - Phone:415-420-7431
Practice Address - Fax:415-447-8665
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23006103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical