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Contact Information

BRIAN CLARK
4718 TENBURY LN
ROCKLIN, CA95677-4487
 Phone: 916-214-9597
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gerontology

225XG0600X 67 Occupational Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for BRIAN CLARK · (Male)

NPI Number 1437548062
Status Active
Credentials
Entity Individual
Enumeration date 01/20/2015
Last updated 01/20/2015 - About 11 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 5857
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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