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General NPI Number Information
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NPI Number | 1972192953
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Entity Type | Organization
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Legal Business Name | CLARITY-JAMES MEDICAL SERVICES CORP
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Dates
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Enumeration Date | 01/13/2021
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 4040 CIVIC CENTER DR STE 200
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City | SAN RAFAEL
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State | CA
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Zip | 94903-4187
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Country | US
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Telephone | 111-111-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 4040 CIVIC CENTER DR STE 200
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City | SAN RAFAEL
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State | CA
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Zip | 94903-4187
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ADAM WOLF WIDEN
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Credential |
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Telephone | 415-795-8050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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