Individual
DERLY CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CDE
Contact information
Practice address
1072 JOHNSON AVE, SAN DIEGO, CA 92103-2316
(858) 499-2700
Mailing address
1072 JOHNSON AVE, SAN DIEGO, CA 92103-2316
(858) 499-2700
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
532905
CA
Other
Enumeration date
02/02/2017
Last updated
02/02/2017
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