DR. MICHELLE OLIVETTE CLARK M.D.
NPI 1164551545
Psychiatry & Neurology - Psychiatry in Alameda, CA

Q: What is Michelle Clark's NPI number?

The NPI number for Michelle Clark is 1164551545. It was assigned to this individual provider in the NPPES registry on March 3, 2007.

Q: What is Michelle Clark's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Q: When was this NPI record last updated?

The NPPES record for Michelle Clark was last updated on February 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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 March 03, 2007PECOS Enrolled

1005 ATLANTIC AVE, ALAMEDA, CA 94501(415) 474-7310 Get Directions Write a Review

NPPES record last updated: February 9, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Michelle Olivette Clark M.d. NPPES

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

DR. MICHELLE OLIVETTE CLARK M.D. (NPI 1164551545) is an individual psychiatry provider in Alameda, California, licensed in California (A 31665) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS and maintains a secondary practice location in Oakland.

NPPES Registry Identity

NPI1164551545

Entity TypeIndividualFemale

Primary Taxonomy2084P0800X

Provider Legal NameDR. MICHELLE OLIVETTE CLARKCredential: M.D.

Location Address1005 ATLANTIC AVEAlameda, CA 94501-1148

Mailing Address4100 Redwood Rd Ste 20a-522Oakland, CA 94619-2363 · (510) 842-8960 · Fax (105) 842-8983

Phone(415) 474-7310

Sole ProprietorYes

Enumeration DateMarch 3, 2007

Last NPPES UpdateFebruary 9, 2023

NPPES CertifiedFebruary 9, 2023

✔ NPI 1164551545 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

License✔ Licensed in CA · A 31665

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

1005 ATLANTIC AVE, Alameda, CA 94501

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Secondary Practice Location 1

Location 14100 Redwood Rd Ste 20A-522Oakland, CA 94619-2363 · Phone (510) 842-8960 · Fax (510) 843-8983

Other Identifiers 1

OtherA 31665CA · State Medical License

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Michelle Olivette Clark M.d. 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 94501 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

$202.35 typical visit price

range $69.00 – $202.35

Typical copayment $50.58 (range $17.25 – $50.58)

Most-billed visit code 99205

Established Patient

$84.91 typical visit price

range $23.44 – $166.46

Typical copayment $21.22 (range $5.86 – $41.61)

Most-billed visit code 99213

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 20

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

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