Individual
DEVIAN CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11783 BRUSH HOLLOW LN, VICTORVILLE, CA 92392-5711
(909) 553-3713
Mailing address
11783 BRUSH HOLLOW LN, VICTORVILLE, CA 92392-5711
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95335693
CA
164X00000X
Licensed Vocational Nurse
287721
CA
Other
Enumeration date
04/14/2023
Last updated
06/15/2023
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