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Individual
LEAH ANN CLARKE
Active
Individual
LEAH ANN CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA20134
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA20134
STATE MEDICAL BOARD PHYSICIAN ASSISTANT LICENSE
CA
Enumeration date
02/11/2008
Last updated
11/10/2015
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