Individual
ANNA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1161 BAY BLVD STE B, CHULA VISTA, CA 91911-2670
(619) 585-7686
Mailing address
1161 BAY BLVD STE B, CHULA VISTA, CA 91911-2670
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/29/2024
Last updated
03/29/2024
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