DR. DERRICK J CLARK PHD
NPI 1568566917
Psychologist in Santa Cruz, CA
NPI Status: Active since September 07, 2006
Contact Information
1663 DOMINICAN WAY
STE 214
SANTA CRUZ, CA
ZIP 95065
Phone: (831) 475-3231
Fax: (831) 462-4936
- Individual
- Male
- Psychologist
About DERRICK CLARK
This page provides the complete NPI Profile along with additional information for Derrick Clark, a provider established in Santa Cruz, California with a medical specialization in Psychologist. The healthcare provider is registered in the NPI registry with number 1568566917 assigned on September 2006. The practitioner's primary taxonomy code is 103T00000X with license number PSY13424 (CA). The provider is registered as an individual and his NPI record was last updated 18 years ago.
- NPI
- 1568566917
- Provider Name
- DR. DERRICK J CLARK PHD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1663 DOMINICAN WAY STE 214 SANTA CRUZ, CA 95065
- Location Phone
- (831) 475-3231
- Location Fax
- (831) 462-4936
- Mailing Address
- 1663 DOMINICAN WAY STE 214 SANTA CRUZ, CA 95065
- Mailing Phone
- (831) 475-3231
- Mailing Fax
- (831) 462-4936
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-07-2006
- Last Update Date
- 07-08-2007
- Code Navigator
A psychologist like Derrick Clark studies cognitive, emotional, social processes and behavior by observing, interpreting, and recording how people relate to one another and to their environments. Psychologists gather information and evaluate behavior through controlled laboratory experiments, psychoanalysis, psychotherapy or through personality, performance, aptitude, or intelligence tests, and use this information when testing theories in their research or when treating patients.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychologist
- Taxonomy Code
- 103T00000X
- Type
- Behavioral Health & Social Service Providers
- License No.
- PSY13424
- License State
- CA
- Taxonomy Description
- A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| OPL134241 | MEDICARE ID-TYPE UNSPECIFIED (04) | ||
| PSY134241 | MEDICAID (05) | CA |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 5 | 6 | 8 | 5 | 6 | 6 | 9 | 1 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 12 | 8 | 10 | 6 | 12 | 9 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 1 + 2 + 8 + 1 + 0 + 6 + 1 + 2 + 9 + 2 + 24 = 63 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 63 = 7 | 7 | ||||||||
The NPI number 1568566917 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 14 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1386759157 | DR. GREGORY LAWRENCE KATZ PH.D. Individual | Psychologist | 1663 DOMINICAN WAY SUITE 214 SANTA CRUZ, CA 95065 (831) 462-0696 |
| 1245340652 | DR. SANJI MARISSA COUTTS PHD Individual | Psychologist | 1663 DOMINICAN WAY SUITE 214 SANTA CRUZ, CA 95065 (831) 462-1761 |
| 1700931086 | SYLVIA L. YEE LMFT Individual | Marriage & Family Therapist | 1663 DOMINICAN WAY #110B SANTA CRUZ, CA 95065 (831) 479-1276 |
| 1265588784 | SAMUEL S. MASTERS M.D. Individual | Ophthalmology | 1663 DOMINICAN WAY SUITE 212 SANTA CRUZ, CA 95065 (831) 475-5375 |
| 1760511158 | RENEE LION LCSW Individual | Social Worker (Clinical) | 1663 DOMINICAN WAY STE 110B SANTA CRUZ, CA 95065 (831) 469-5349 |
| 1346373487 | DR. ANDREW K KUMASAKA M.D. Individual | Psychiatry & Neurology (Psychiatry) | 1663 DOMINICAN WAY SUITE 214 SANTA CRUZ, CA 95065 (831) 479-0333 |
| 1619096088 | MR. KEITH BRITANY MFT Individual | Marriage & Family Therapist | 1663 DOMINICAN WAY SUITE 110B SANTA CRUZ, CA 95065 (831) 566-3728 |
| 1881869337 | GEORGE M. YELLICH, DDS, MS., INC. AND CHENG, DDS, MD, INC, PARTNERSHIP Organization | Dentist (Oral and Maxillofacial Surgery) | 1663 DOMINICAN WAY SUITE 112 SANTA CRUZ, CA 95065 (831) 475-0221 |
| 1497077416 | GLENN E. HARPER, M.D., INC. Organization | Neurological Surgery | 1663 DOMINICAN WAY SUITE 210 SANTA CRUZ, CA 95065 (831) 462-5500 |
| 1174833669 | PAUL LUTHER MD, A PROFESSIONAL CORPORATION Organization | Psychiatry & Neurology (Psychiatry) | 1663 DOMINICAN WAY SUITE 214 SANTA CRUZ, CA 95065 (831) 809-6766 |
| 1972821213 | ANDREA GAYE EDWARDS MD INC Organization | Internal Medicine (Hematology & Oncology) | 1663 DOMINICAN WAY SUITE 210 SANTA CRUZ, CA 95065 (831) 475-8002 |
| 1942372123 | BEHAVIORAL HEALTH CARE, INC. Organization | Psychologist (Counseling) | 1663 DOMINICAN WAY SUITE 214 SANTA CRUZ, CA 95065 (831) 464-5800 |
| 1083728414 | DR. CHIEN YUAN CHENG DDS MD Individual | Dentist (Oral and Maxillofacial Surgery) | 1663 DOMINICAN WAY SUITE 112 SANTA CRUZ, CA 95065 (831) 475-0221 |
| 1841304276 | DR. GEORGE MICHAEL YELLICH DDS MS Individual | Dentist (Oral and Maxillofacial Surgery) | 1663 DOMINICAN WAY SUITE 112 SANTA CRUZ, CA 95065 (831) 475-0221 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1568566917, enumerated in the NPI registry as an "individual" on September 07, 2006
The provider is located at 1663 Dominican Way Ste 214 Santa Cruz, Ca 95065 and the phone number is (831) 475-3231
The provider's speciality is Psychologist with taxonomy code 103T00000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on September 07, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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