| Doctor Name: | MS. ROXANNE JOY CLARK |
| NPI Number: | 1194845818 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CAARR |
| License Number: | CAARR |
| Business Practice Address: | 1904 Richland Ave Ceres, CA - 953074562 |
| Business Phone Number: | 2095412153 |
| Business Fax Number: | |
| Mailing Address: | 270 Lambuth Ave, Apt B OAKDALE |
| State: | CA |
| Postal Code: | 953612802 |
| Phone Number: | 2093032755 |
| Fax Number: | |
| NPI Enumeration Date: | 03/29/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | CAARR |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |