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Individual

KHYRISTIENNE CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
11301 WILSHIRE BLVD BLDG 304, LOS ANGELES, CA 90073-1003
(310) 478-3711
Mailing address
9636 S HARVARD BLVD, LOS ANGELES, CA 90047-3814
(747) 295-3999

Taxonomy

Speciality
Code
Description
License number
State
156FX1202X
Optometric Technician
Primary
CA

Other

Enumeration date
09/04/2025
Last updated
09/04/2025
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