Dmitrius Clark

Behavior Technician · Stockton, CA

Individual Active NPI

NPI number 1003386657

Practice location

3620 W. Hammer Lane
Stockton, CA 95219
Phone
(209) 521-4791

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NPI record

NPI
1003386657
Entity type
Individual (Type 1)
Enumeration date
November 27, 2018
Last updated
November 27, 2018
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Behavior Technician Primary 106S00000X — —

Mailing address

3425 Coffee Rd Suite C2
Modesto, CA 95355

About Dmitrius Clark

Dmitrius Clark is a healthcare provider registered in the NPI registry with the primary taxonomy Behavior Technician (code 106S00000X). The practice location is 3620 W. Hammer Lane, Stockton, CA 95219. The NPI number 1003386657 was assigned on November 27, 2018 and the record was last updated on November 27, 2018.

Frequently asked questions

What is the NPI number of Dmitrius Clark?

The NPI number is 1003386657.

What is the phone number of Dmitrius Clark?

The phone number listed for the practice location is (209) 521-4791.

Where is Dmitrius Clark located?

3620 W. Hammer Lane, Stockton, CA 95219.

What is the taxonomy code for Dmitrius Clark?

The primary taxonomy code is 106S00000X – Behavior Technician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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