Provider Demographics
NPI:1821245911
Name:CLAY, APRIL GARNETTA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:APRIL
Middle Name:GARNETTA
Last Name:CLAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11081 LIVE OAK LN
Mailing Address - Street 2:
Mailing Address - City:ADELANTO
Mailing Address - State:CA
Mailing Address - Zip Code:92301-3681
Mailing Address - Country:US
Mailing Address - Phone:760-246-6767
Mailing Address - Fax:
Practice Address - Street 1:11081 LIVE OAK LN
Practice Address - Street 2:
Practice Address - City:ADELANTO
Practice Address - State:CA
Practice Address - Zip Code:92301-3681
Practice Address - Country:US
Practice Address - Phone:760-246-6767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA19143363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant