Individual
CARRIE-ANNE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 E VALENCIA MESA DR, SUITE 105, FULLERTON, CA 92835-3813
(714) 446-5200
(714) 446-5292
Mailing address
100 E VALENCIA MESA DR STE 105, FULLERTON, CA 92835-3816
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA17731
CA
Other
Enumeration date
05/22/2007
Last updated
10/20/2021
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