MS. ANITRA M CLARK (LCSW) – Clinical Social Worker, NPI 1649280595

MS. ANITRA M CLARK (LCSW) is a healthcare provider. based in San leandro, California. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 26654 (CA). The NPI Number for MS. ANITRA M CLARK (LCSW) is 1649280595

Main info

Female
Sole Proprietor
25 Years Of Experience
Accepts Medicare Assignment
Name
MS. ANITRA M CLARK (LCSW)
NPI
1649280595
Phone
(510) 241-2373
Address
375 ESTUDILLO AVE, STE 207
Enumeration Date
9 August 2006
Last Update Date
4 June 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5107521075
Graduation Year
2001 (25 years ago)
PAC ID
2163611120
Group Practice PAC ID
8921910225
Professional Enrollment ID
I20110106001015
Address ID
CA946115616OA3900XBROA200

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq
Data current as of
10 June 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience66
Completeness95
Years active:19State licenses:2Other names

4,987 CLINICAL SOCIAL WORKER in CA

Provider Addresses for MS. ANITRA M CLARK (LCSW)

  • 375 ESTUDILLO AVE, STE 207

    SAN LEANDRO, CA 94577

    Phone: (510) 241-2373

    Fax: (614) 455-1945

    Type: Location

  • 345 ESTUDILLO AVE STE 207

    SAN LEANDRO, CA 945774727

    Phone: (510) 241-2373

    Fax: (614) 455-1945

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-01-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110106001015IClinical Social WorkerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 94577)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8921910225View full group profile
NameSpecialtyState
Emergency MedicineDC
Colorectal Surgery (Proctology), General SurgeryLA
-CA
N E U R O S U R G E R YMA
Internal MedicineCA
Nurse PractitionerCA
Internal MedicineCA
Emergency MedicineCA
-MA
Emergency MedicineCA

Reviews

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Frequently asked questions

What identifier follows MS. ANITRA M CLARK (LCSW) across health systems?
The NPI 1649280595 uniquely identifies MS. ANITRA M CLARK (LCSW) in U.S. healthcare data.
Is MS. ANITRA M CLARK (LCSW)'s NPI status active today?
Active status means MS. ANITRA M CLARK (LCSW)'s NPI record is not deactivated in the public file.
Which specialty label fits MS. ANITRA M CLARK (LCSW)?
NPPES ties MS. ANITRA M CLARK (LCSW) to Clinical Social Worker in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to MS. ANITRA M CLARK (LCSW)?
The directory associates MS. ANITRA M CLARK (LCSW) with San Leandro, California. Check all listed addresses for suites or satellite offices.
Who maintains MS. ANITRA M CLARK (LCSW)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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