Individual
MS. LESLIE ERIN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, NP
Contact information
Practice address
5671 SANTA TERESA BLVD, 105, SAN JOSE, CA 95123-6512
(408) 284-2280
Mailing address
39865 CEDAR BLVD, 343, NEWARK, CA 94560-5352
(510) 449-5298
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
589440
CA
164W00000X
Licensed Practical Nurse
Primary
20397
CA
Other
Enumeration date
11/22/2011
Last updated
11/22/2011
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