DR. DERRICK J CLARK PHD
NPI 1568566917
Psychologist in Santa Cruz, CA

Active since September 07, 2006
1663 DOMINICAN WAY, STE 214, SANTA CRUZ, CA 95065(831) 475-3231(831) 462-4936 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Derrick J Clark Phd NPPES

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

DR. DERRICK J CLARK PHD (NPI 1568566917) is an individual psychologist in Santa Cruz, California, licensed in California (PSY13424) and active in the NPI registry since September 2006.

NPPES Registry Identity

NPI1568566917
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. DERRICK J CLARKCredential: PHD
Location Address1663 DOMINICAN WAY, STE 214Santa Cruz, CA 95065-1527
Mailing Address1663 Dominican Way, Ste 214Santa Cruz, CA 95065-1527 · (831) 475-3231 · Fax (831) 462-4936
Fax(831) 462-4936
Sole ProprietorNo
Enumeration DateSeptember 7, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1568566917 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in CA · PSY13424
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
1663 DOMINICAN WAY, Santa Cruz, CA 95065

Other Identifiers 2

Medicare ID-Type UnspecifiedOPL134241
MedicaidPSY134241CA

Other Providers at the Same Location NPPES 14

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

Dentist (Oral and Maxillofacial Surgery)
1663 DOMINICAN WAY, SUITE 112
SANTA CRUZ, CA 95065
Psychiatry & Neurology (Psychiatry)
1663 DOMINICAN WAY, SUITE 214
SANTA CRUZ, CA 95065
Psychologist
1663 DOMINICAN WAY, SUITE 214
SANTA CRUZ, CA 95065
Ophthalmology
1663 DOMINICAN WAY, SUITE 212
SANTA CRUZ, CA 95065
Psychiatry & Neurology (Psychiatry)
1663 DOMINICAN WAY, SUITE 214
SANTA CRUZ, CA 95065
Psychologist
1663 DOMINICAN WAY, SUITE 214
SANTA CRUZ, CA 95065
Neurological Surgery
1663 DOMINICAN WAY, SUITE 210
SANTA CRUZ, CA 95065
Marriage & Family Therapist
1663 DOMINICAN WAY, SUITE 110B
SANTA CRUZ, CA 95065

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 Derrick Clark's NPI number?

The NPI number for Derrick Clark is 1568566917. It was assigned to this individual provider in the NPPES registry on September 7, 2006.

Where is Derrick Clark located?

Derrick Clark practices at 1663 Dominican Way Ste 214, Santa Cruz, CA 95065. The listed phone number is (831) 475-3231.

What is Derrick Clark's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

When was this NPI record last updated?

The NPPES record for Derrick Clark was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.