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Individual

AMY J. CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, IBCLC

Contact information

Practice address
731 18TH AVE, SAN FRANCISCO, CA 94121-3824
(415) 254-5349
Mailing address
731 18TH AVE, SAN FRANCISCO, CA 94121-3824
(415) 254-5349

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
520681
CA
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
11270710
CA

Other

Enumeration date
11/16/2012
Last updated
11/16/2012
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