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General NPI Number Information
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NPI Number | 1669582979
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Entity Type | Organization
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Legal Business Name | CLIPSON & OSTERLOH, APC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3921 GOLDFINCH ST
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City | SAN DIEGO
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State | CA
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Zip | 92103-2926
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Country | US
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Telephone | 619-260-0335
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Fax | 619-260-1682
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Provider Business Mailing Address
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Address Line | 3921 GOLDFINCH ST
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City | SAN DIEGO
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State | CA
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Zip | 92103-2926
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Country | US
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Telephone | 619-260-0335
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Fax | 619-260-1682
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. CLARK RICHARD CLIPSON
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Credential | PH D
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Telephone | 619-260-0335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PSY 7669
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY 7669
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | PSY 7669
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License Number State | CA
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