IndividualActive
Stacy Clark
NPI 1104676790 · Behavior Technician · Stockton, CA
Stacy Clark is a Behavior Technician provider in Stockton, CA (NPI 1104676790).
Provider details
- NPI number
- 1104676790
- Entity type
- Individual
- Primary specialty
- Behavior TechnicianBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(50/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2453 Grand Canal Blvd Ste a
Stockton, CA 95207-8138
Phone: (855) 223-7123
Street-level locationGet directions
Mailing address
Po Box 33568
San Diego, CA 92163-3568
Registry dates
- Enumerated
- 2024-03-25
- Last updated
- 2024-03-25
- Certified
- 2024-03-25
Frequently asked questions
- What is Stacy Clark's NPI number?
- Stacy Clark's National Provider Identifier (NPI) is 1104676790, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Stacy Clark's specialty?
- Stacy Clark is listed in the NPPES registry with a primary specialty of Behavior Technician (Behavioral Health & Social Service Providers).
- Where is Stacy Clark located?
- Stacy Clark's practice location on file with NPPES is 2453 Grand Canal Blvd Ste a, Stockton, CA 95207-8138.
- What is Stacy Clark's phone number?
- The practice phone number listed in the NPPES registry for Stacy Clark is (855) 223-7123.
- Is Stacy Clark's NPI active?
- Yes — Stacy Clark's NPI (1104676790) is active in the NPPES registry as of the last update on 2024-03-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.