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Leacha M Clark, ASW
Student in an Organized Health Care Education/Training Program in Ione, California
NPI 1366187676

Leacha M Clark is a Student in an Organized Health Care Education/Training Program based in Sacramento, CA. Leacha M Clark practices in Ione, CA and has the professional credentials of ASW. The NPI Number for Leacha M Clark is 1366187676 and holds a License No. 106588 (California).

The current practice location address for Leacha M Clark is 4001 Ca-104, Ione, CA and can be reached out via phone at 209-274-4911.

Location: 4001 Ca-104, Ione, CA, 95834-2122
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1366187676
Provider Name
Leacha M Clark
Credential
ASW
Provider Entity Type
Individual
Gender
Female
Address
4001 Ca-104, Ione, CA, 95834-2122
Phone Number
209-274-4911
Fax Number
Provider Enumeration Date
05/02/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4001 Ca-104
City
Ione
State
California
Zip
95640
Phone Number
209-274-4911
Fax Number
person
Provider Business Mailing Address Details
Address
4001 Ca-104
City
Ione
State
California
Zip
95640
Phone Number
209-274-4911
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
106588 (California)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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