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Contact Information

SHAYNA CLARK
720 WOOD ST
EUREKA, CA95501-4413
 Phone: 707-268-2900
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Licensed Psychiatric Technician

167G00000X
 

Case Manager/Care Coordinator

171M00000X
Indicates primary specialty

NPI Profile & details for SHAYNA CLARK · (Female)

NPI # 1649559352
Status Active
Credentials
Entity Individual
Enumeration date 08/11/2011
Last updated 11/30/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • CA License # PT36132
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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