Individual
CHLOE CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
360 WHISKEY HILL RD, WATSONVILLE, CA 95076-8521
(831) 724-9333
Mailing address
360 WHISKEY HILL RD, WATSONVILLE, CA 95076-8521
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ91892Z
SANTA CRUZ COUNTY MEDICARE GROUP PTAN#
CA
Enumeration date
09/13/2016
Last updated
09/13/2016
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