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General NPI Number Information
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NPI Number | 1821525882
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Entity Type | Individual
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Provider Name | DR. ALYCIA CLARK
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Gender | Female
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Dates
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Enumeration Date | 05/20/2017
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Last Update Date | 06/11/2021
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Provider Practice Location Address
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Address Line | 6100 WALLACE BECKNELL RD
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City | SANTA BARBARA
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State | CA
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Zip | 93117-3265
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Country | US
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Telephone | 858-335-8990
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Fax |
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Provider Business Mailing Address
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Address Line | 175 SANTA ELENA LN
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City | SANTA BARBARA
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State | CA
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Zip | 93108-2512
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Country | US
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Telephone | 858-335-8990
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 62657
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License Number State | CA
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