MS. PATRICIA ANN CLARK MFTI
NPI 1073937637
Marriage & Family Therapist in Santa Rosa, CA

Q: What is Patricia Clark's NPI number?

The NPI number for Patricia Clark is 1073937637. It was assigned to this individual provider in the NPPES registry on February 18, 2014.

Q: What is Patricia Clark's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: Is Patricia Clark enrolled in Medicare?

No. Patricia Clark has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Patricia Clark was last updated on February 18, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since February 18, 2014Opted out of Medicare · through Jan 1, 2028

429 SPEERS RD, SANTA ROSA, CA 95409(707) 571-2215 Get Directions Write a Review

NPPES record last updated: February 18, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Ms. Patricia Ann Clark Mfti NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. PATRICIA ANN CLARK MFTI (NPI 1073937637) is an individual marriage & family therapist in Santa Rosa, California, licensed in California (IMF 75971) and active in the NPI registry since February 2014. She has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1073937637

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameMS. PATRICIA ANN CLARKCredential: MFTI

Location Address429 SPEERS RDSanta Rosa, CA 95409-3123

Mailing AddressPo Box 2587Santa Rosa, CA 95405-0587 · (707) 527-2215

Phone(707) 571-2215

Sole ProprietorNo

Enumeration DateFebruary 18, 2014

✔ NPI 1073937637 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · IMF 75971

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

429 SPEERS RD, Santa Rosa, CA 95409

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Other Names 1

Professional Name (2)Ann Clark Mfti

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Ms. Patricia Ann Clark Mfti has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024

Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHERI ANN SANDBERG NP

Nurse Practitioner (Family)