Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CLYDE CHILDRESS JR.
Active Sole ProprietorCLYDE CHILDRESS JR. is a Counselor healthcare provider located in SAN RAFAEL, California. NPI 1376998898 is currently active in the NPPES registry. Verify at CMS.
Counselor · SAN RAFAEL, CA
Registration Details
- NPI Number
- 1376998898
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 3, 2016 (10.277578406234 yrs)
- Last Updated
- May 3, 2016
- License
-
C1106010028 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1466 LINCOLN AVESAN RAFAEL, CA, 949012021Browse CA providers · Browse ZIP 94901
- Phone
- 4154573755
- Primary Specialty
-
Counselor
101Y00000X
Other Counselor Providers in SAN RAFAEL, CA
| Name | Credential | NPI |
|---|---|---|
| EILEEN BECKER | — | 1669587135 |
| LAURA WILSON | — | 1770667552 |
| MR. ERIC SCOTT ROBERTS | BA | 1972688927 |
| MS. DEE W SCHWEITZER | ATR-BC | 1326100082 |
| YOLANDA MARQUEZ | — | 1730246414 |
| CHARLOTTE FULLER | — | 1336296540 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.