Individual
ALIA KEHAULANI CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1135 MARSH ST, SAN LUIS OBISPO, CA 93401-3323
(805) 465-9847
(805) 666-1029
Mailing address
1135 MARSH ST, SAN LUIS OBISPO, CA 93401-3323
(805) 465-9847
(805) 666-1029
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
L-318699
CA
176B00000X
Midwife
Primary
533
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
533
LICENSED MIDWIFE
CA
Enumeration date
04/19/2018
Last updated
07/17/2025
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