NPI 1003386657

Dmitrius Clark

Practitioner Behavior Technician Stockton, CA

Practice location

Address: 3620 W. Hammer Lane, Stockton, CA 95219
Phone: (209) 521-4791
Mailing address: 3425 Coffee Rd Suite C2, Modesto, CA 95355

Registered specialties

Behavior Technician Primary

Behavioral Health & Social Service Providers Taxonomy 106S00000X

Other Behavior Technician providers in California →

Registry record

NPI: 1003386657
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Nov 2018
Record last updated: 27 Nov 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.