Provider Demographics
NPI:1811880164
Name:CLARKE, ALLISON ADELINA (MA, EDS, NCSP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:ADELINA
Last Name:CLARKE
Suffix:
Gender:F
Credentials:MA, EDS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5495 NORTHWIND CT APT 104
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-0469
Mailing Address - Country:US
Mailing Address - Phone:818-357-8109
Mailing Address - Fax:
Practice Address - Street 1:760 JAZMIN AVE
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93004-1826
Practice Address - Country:US
Practice Address - Phone:805-672-2701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool