Joshua Wayne Clark

NPI #1053197517 in Phelan, California

Provider Information

NPI Number: 1053197517
Entity Type: Individual
Name: Joshua Wayne Clark
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Psychologist - Intellectual & Developmental Disabilities
Enumeration Date: Aug 31, 2023
Last Updated: Aug 31, 2023

Practice Location

Address: 4037 STE A 214
City: Phelan
State: California
ZIP Code: 92371
Phone: (760) 964-0153

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Intellectual & Developmental Disabilities — Intellectual & Developmental Disabilities	103TM1800X	Primary

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