Provider Demographics
NPI:1821347030
Name:FELARCA, CLIFFORD UGALDE (NP)
Entity Type:Individual
Prefix:MR
First Name:CLIFFORD
Middle Name:UGALDE
Last Name:FELARCA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3075 HEALTH CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2773
Mailing Address - Country:US
Mailing Address - Phone:858-264-7423
Mailing Address - Fax:858-636-2610
Practice Address - Street 1:3075 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2773
Practice Address - Country:US
Practice Address - Phone:858-264-7423
Practice Address - Fax:858-636-2610
Is Sole Proprietor?:No
Enumeration Date:2012-09-04
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP21902363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP21902OtherCALIFORNIA - BOARD OF REGISTERED NURSING