Camellia Clark, M.D.
NPI 1174624399 · Psychiatry Physician · San Diego, CA
Enrolled with Medicare as Practitioner - Psychiatry · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Camellia Clark, M.D. is a Psychiatry Physician provider in San Diego, CA (NPI 1174624399).
Provider details
- NPI number
- 1174624399
- Entity type
- Individual
- Primary specialty
- Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- License
- A052116 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
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
Mailing address
Additional practice locations (2)
- 7850 Vista Hill AveSan Diego, CA 92123-2717Phone: (619) 528-4600Fax: (619) 528-4625
- 9620 Chesapeake Dr Ste 206San Diego, CA 92123-1324Phone: (619) 814-6590Fax: (619) 814-6591
Registry dates
- Enumerated
- 2006-09-26
- Last updated
- 2021-03-25
- Certified
- 2021-03-25
Frequently asked questions
- What is Camellia Clark's NPI number?
- Camellia Clark's National Provider Identifier (NPI) is 1174624399, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Camellia Clark's specialty?
- Camellia Clark is listed in the NPPES registry with a primary specialty of Psychiatry Physician (Allopathic & Osteopathic Physicians).
- Where is Camellia Clark located?
- Camellia Clark's practice location on file with NPPES is 4550 Kearny Villa Rd Ste 116, San Diego, CA 92123-1583.
- What is Camellia Clark's phone number?
- The practice phone number listed in the NPPES registry for Camellia Clark is (858) 279-1223.
- Does Camellia Clark accept Medicare?
- Camellia Clark is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Camellia Clark's NPI active?
- Yes — Camellia Clark's NPI (1174624399) is active in the NPPES registry as of the last update on 2021-03-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.