MEDICARE: CLARIE EMILY DEIERHOI-CLARK PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PSY31224	CA

General Provider Information

NPI Number	:	1083015333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLARIE EMILY DEIERHOI-CLARK PHD

Provider Business Mailing Address
First Line	:	2535 KETTNER BLVD STE 2B1
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-1253
Country	:	US
Telephone Number	:	619-512-9451
Fax Number	:

Provider Business Practice Location Address
First Line	:	2535 KETTNER BLVD STE 2B1
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-1253
Country	:	US
Telephone Number	:	619-512-9451
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2014
Last Update Date	:	03/08/2021

Similar Medicare Providers

1881914000 — GRUPO MEDICO POLICLINICA SAN PEDRO MEDICARE ADVANTAGE
Practice Location Address:

211 CALLE MORSE
ARROYO, PR
00714-2350

Practice Phone: 787-839-3980
Practice Fax: 787-271-2515

1922311489 — DR. SEAN H KIM D.C.
Practice Location Address:

2535 KETTNER BLVD STE 2A3
SAN DIEGO, CA
92101-1253

Practice Phone: 619-501-7873
Practice Fax:

1376985788 — LAUREN STERN
Practice Location Address:

2535 KETTNER BLVD STE 2B1
SAN DIEGO, CA
92101-1253

Practice Phone: 469-235-2941
Practice Fax:

1275050031 — DR. CHRISTIAN GARNICA PSYD
Practice Location Address:

2535 KETTNER BLVD STE 2B1
SAN DIEGO, CA
92101-1253

Practice Phone: 619-800-4471
Practice Fax:

1003474180 — WISE SELF PSYCHOLOGY, INC.
Practice Location Address:

2535 KETTNER BLVD STE 2B1
SAN DIEGO, CA
92101-1253

Practice Phone: 619-678-0020
Practice Fax:

1306534219 — DEIERHOI-CLARK PSYCHOLOGY, A PROFESSIONAL ORGANIZATION
Practice Location Address:

2535 KETTNER BLVD STE 2B1
SAN DIEGO, CA
92101-1253

Practice Phone: 619-512-9451
Practice Fax: 619-821-9721

Directions to “ CLARIE EMILY DEIERHOI-CLARK PHD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.