Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

CAROLYN CLARK AC-CRNP-PMH
NPI 1124429857
Nurse Practitioner - Psychiatric/Mental Health in Carlsbad, CA

Q: What is Carolyn Clark's NPI number?

The NPI number for Carolyn Clark is 1124429857. It was assigned to this individual provider in the NPPES registry on September 12, 2014.

Q: What is Carolyn Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Carolyn Clark was last updated on August 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 12, 2014PECOS Enrolled

6010 HIDDEN VALLEY RD STE 115, CARLSBAD, CA 92011(760) 797-8494 Get Directions Write a Review

NPPES record last updated: August 14, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 14, 2026, Sep 3, 2020 (2 updates tracked since 2020).

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About Carolyn Clark Ac-crnp-pmh NPPES

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

CAROLYN CLARK AC-CRNP-PMH (NPI 1124429857) is an individual psychiatric/mental health provider in Carlsbad, California, licensed in California (NP95013648) and active in the NPI registry since September 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124429857

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameCAROLYN CLARKCredential: AC-CRNP-PMH

Location Address6010 HIDDEN VALLEY RD STE 115Carlsbad, CA 92011-4219

Mailing Address3835 N Freeway Blvd Ste 100Sacramento, CA 95834-1954

Phone(760) 797-8494

Sole ProprietorNo

Enumeration DateSeptember 12, 2014

Last NPPES UpdateAugust 14, 20262 updates tracked since enumeration

NPPES CertifiedAugust 14, 2026

✔ NPI 1124429857 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

Licenses✔ Licensed in CA · NP95013648✔ Licensed in MD · AC001401

6010 HIDDEN VALLEY RD STE 115, Carlsbad, CA 92011

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carolyn Clark Ac-crnp-pmh is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92011 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.87 typical visit price

range $62.10 – $184.71

Typical copayment $23.71 (range $15.52 – $46.17)

Most-billed visit code 99203

Established Patient

$108.42 typical visit price

range $20.62 – $151.42

Typical copayment $27.10 (range $5.15 – $37.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

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

MICHAEL RYAN BUCHHOLZ

Psychiatry & Neurology (Psychiatry)