Individual
JANELISE S CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
14355 MIRANDA WAY, LOS ALTOS HILLS, CA 94022-2032
(650) 546-7775
Mailing address
4254 W ORCHID LN, CHANDLER, AZ 85226-7246
(888) 731-8994
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
NP661A
ID
363LP0200X
Pediatric Nurse Practitioner
Primary
NUR-APRN-LIC-125338
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010160650
REGENCE
ID
01
—
300936
ALTIUS HEALTH PLANS
ID
05
—
806937600
—
ID
01
—
P00393459
RAILROAD MEDICARE
ID
Enumeration date
11/07/2006
Last updated
05/19/2025
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