Individual
MRS. CHERIE CHRISTINE-VIVONA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
EDEN EMERGENCY DEPARTMENT, 20103 LAKE CHABOT ROAD, CASTRO VALLEY, CA 94546
(510) 727-3320
(510) 727-2745
Mailing address
EDEN EMERGENCY DEPARTMENT, 20103 LAKE CHABOT ROAD, CASTRO VALLEY, CA 94546
(510) 727-3320
(510) 727-2745
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
21127
CA
Other
Enumeration date
09/15/2010
Last updated
03/31/2020
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