Individual
DONNA M CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
GNP
Contact information
Practice address
130 CEDAR RD STE 200, VISTA, CA 92083-5102
(760) 806-5620
(760) 806-5639
Mailing address
10170 SORRENTO VALLEY RD, SAN DIEGO, CA 92121-1604
(858) 784-5888
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN485608
CA
163WD0400X
Diabetes Educator Registered Nurse
RN485608
CA
163WG0600X
Gerontology Registered Nurse
RN485608
CA
363LG0600X
Gerontology Nurse Practitioner
Primary
6328
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN485608
—
CA
Enumeration date
08/01/2006
Last updated
08/02/2013
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