Individual
JENNIFER ALEXANDRIA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
99 MONTECILLO RD, SAN RAFAEL, CA 94903-3308
(925) 229-7693
Mailing address
20 BARNESON AVE, #C, SAN MATEO, CA 94402-2978
(310) 266-2796
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
086522
CA
Other
Enumeration date
02/24/2011
Last updated
01/11/2022
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