Healthcare Provider Details

I. General information

NPI: 1740125210
Provider Name (Legal Business Name): ZOE R CLARK MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 DE LA CRUZ BLVD STE 310
SANTA CLARA CA
95054-2452
US

IV. Provider business mailing address

1700 N 1ST ST APT 166
SAN JOSE CA
95112-4570
US

V. Phone/Fax

Practice location:
  • Phone: 408-350-3200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: