JAMES WILLIAM CLARK
NPI 1093225153
Social Worker - School in Santa Fe Springs, CA

Q: What is James Clark's NPI number?

The NPI number for James Clark is 1093225153. It was assigned to this individual provider in the NPPES registry on October 3, 2017.

Q: What is James Clark's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in School, with taxonomy code 1041S0200X.

Q: When was this NPI record last updated?

The NPPES record for James Clark was last updated on May 7, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 03, 2017PECOS EnrolledAccepts Medicare Assignment

11015 BLOOMFIELD AVE, SANTA FE SPRINGS, CA 90670(562) 906-2676 Get Directions Write a Review

NPPES record last updated: May 7, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 7, 2024, Nov 2, 2023 (2 updates tracked since 2023).

On this page

About James William Clark NPPES

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

JAMES WILLIAM CLARK (NPI 1093225153) is an individual school provider in Santa Fe Springs, California and active in the NPI registry since October 2017. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1093225153

Entity TypeIndividualMale

Primary Taxonomy1041S0200X

Provider Legal NameJAMES WILLIAM CLARK

Location Address11015 BLOOMFIELD AVESanta Fe Springs, CA 90670-4601

Mailing Address11015 Bloomfield AveSanta Fe Springs, CA 90670-4601 · (562) 906-2676

Phone(562) 906-2676

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateOctober 3, 2017

Last NPPES UpdateMay 7, 20242 updates tracked since enumeration

NPPES CertifiedNovember 2, 2023

✔ NPI 1093225153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · SchoolBehavioral Health & Social Service Providers

Taxonomy Code1041S0200X

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X

11015 BLOOMFIELD AVE, Santa Fe Springs, CA 90670

Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

James William Clark is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9638510613

PECOS Enrollment IDI20240508000908

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

SANDRA SUE DALTON CATC

Counselor (Addiction (Substance Use Disorder))