Search › California › 101Y00000X
Clyde Childress
NPI 1376998898 · on the registry since 2016 · sole proprietor
Practice
- Address
- 1466 Lincoln Ave
San Rafael, CA 94901 - Phone
- (415) 457-3755
- Organisation at this address
- Marin Treatment Center
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 65
Registry record
- Primary taxonomy
- 101Y00000X
101Y00000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-05-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California