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CHAMPAGNE CLARK
NPI 1306323563
Social Worker - Clinical in West Sacramento, CA

Active since July 20, 2018PECOS Enrolled
500B JEFFERSON BLVD, WEST SACRAMENTO, CA 95605(916) 403-2990 Get Directions Write a Review

NPPES record last updated: December 30, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 30, 2021, Oct 14, 2019, Jul 20, 2018 (3 updates tracked since 2018).

About Champagne Clark NPPES

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

CHAMPAGNE CLARK (NPI 1306323563) is an individual clinical provider in West Sacramento, California, licensed in California (92250) and active in the NPI registry since July 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1306323563
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameCHAMPAGNE CLARK
Location Address500B JEFFERSON BLVDWest Sacramento, CA 95605-2349
Mailing Address155 Lily Bay CirSacramento, CA 95834-7764 · (323) 308-5037
Phone(916) 403-2990
Sole ProprietorNo
Enumeration DateJuly 20, 2018
Last NPPES UpdateDecember 30, 20213 updates tracked since enumeration
✔ NPI 1306323563 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · 92250
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
500B JEFFERSON BLVD, West Sacramento, CA 95605
Open in Google Maps ↗

Other Identifiers 1

Medicaid000603CA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Champagne Clark 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 95605 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
$0.00 typical visit price
range $60.44 – $180.85
Typical copayment $0.00 (range $15.11 – $45.21)
Most-billed visit code NA
Established Patient
$75.03 typical visit price
range $19.88 – $148.15
Typical copayment $18.75 (range $4.97 – $37.03)
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 5

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

SAMANTHA ANN MERO
Counselor (Mental Health)
500B JEFFERSON BLVD
WEST SACRAMENTO, CA 95605
Yolo County (916) 403-2990
JESSICA MOLINA
Student in an Organized Health Care Education/Training Program
500B JEFFERSON BLVD, #180
WEST SACRAMENTO, CA 95605
Yolo County (916) 403-2900
LAURIE GATES PEER SUPPORT WORKER
Peer Specialist
500B JEFFERSON BLVD
WEST SACRAMENTO, CA 95605
Yolo County (530) 702-3805
DR. NICHOLAS GEORGE CORNES MD
Psychiatry & Neurology (Psychiatry)
500B JEFFERSON BLVD, SUITE 150
WEST SACRAMENTO, CA 95605
Yolo County (916) 375-6350
OLE HEALTH
Clinic/Center (Federally Qualified Health Center (FQHC))
500B JEFFERSON BLVD, SUITE 180 & 195
WEST SACRAMENTO, CA 95605
Yolo County (916) 403-2900

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Champagne Clark's NPI number?

The NPI number for Champagne Clark is 1306323563. It was assigned to this individual provider in the NPPES registry on July 20, 2018.

Where is Champagne Clark located?

Champagne Clark practices at 500B Jefferson Blvd, West Sacramento, CA 95605. The listed phone number is (916) 403-2990.

What is Champagne Clark's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Champagne Clark enrolled in Medicare?

Yes. Champagne Clark is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Champagne Clark was last updated on December 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.