Provider Demographics
NPI:1003686437
Name:CLARK, AMBER TRESSA (PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:TRESSA
Last Name:CLARK
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6790 E CALLE LA PAZ UNIT 5201
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-9011
Mailing Address - Country:US
Mailing Address - Phone:562-202-2883
Mailing Address - Fax:
Practice Address - Street 1:6790 E CALLE LA PAZ UNIT 5201
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-9011
Practice Address - Country:US
Practice Address - Phone:562-202-2883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ274168363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health