Provider Demographics
NPI:1891944088
Name:CLARK, DAWN MARIE (NP)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:CLARK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1260 S MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2288
Mailing Address - Country:US
Mailing Address - Phone:831-769-9355
Mailing Address - Fax:831-754-4955
Practice Address - Street 1:1260 S MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2288
Practice Address - Country:US
Practice Address - Phone:831-769-9355
Practice Address - Fax:831-754-4955
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA18186363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health