Provider Demographics
NPI:1952412165
Name:FRANKE-CLARK, MARGOT JOAN (PSYD)
Entity Type:Individual
Prefix:
First Name:MARGOT
Middle Name:JOAN
Last Name:FRANKE-CLARK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 COLLEGE PARK
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-3643
Mailing Address - Country:US
Mailing Address - Phone:530-756-0318
Mailing Address - Fax:
Practice Address - Street 1:5030 EL CAMINO AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-4650
Practice Address - Country:US
Practice Address - Phone:916-609-4984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB31103103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical