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General NPI Number Information
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NPI Number | 1669322095
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Entity Type | Individual
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Provider Name | SAMANTHA MARIE CLARK
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Gender | Female
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Dates
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Enumeration Date | 02/03/2026
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 44750 60TH ST W
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City | LANCASTER
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State | CA
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Zip | 93536-7619
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Country | US
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Telephone | 661-729-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 10949 CARTWRIGHT DR
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City | CHATSWORTH
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State | CA
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Zip | 91311-1961
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Country | US
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Telephone | 732-995-5537
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ASW130991
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License Number State | CA
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