Grace Enu Clerk, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP95016640 Issued in CA

Practice address

35237 Yucaipa Blvd
Yucaipa, CA 92399-4340

Phone

(909) 790-6200

Fax

(909) 790-6220

NPI assigned

Aug 21, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Redlands Community Hospital

  • General Acute Care Hospital
  • Redlands, CA
  • NPI 1043354111
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629504000000",
    "number": "1093481772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35237 YUCAIPA BLVD",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923994340",
            "telephone_number": "909-790-6200",
            "fax_number": "909-790-6220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35237 YUCAIPA BLVD",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923994340",
            "telephone_number": "909-790-6200",
            "fax_number": "909-790-6220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLERK",
        "first_name": "GRACE",
        "middle_name": "ENU",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-21",
        "last_updated": "2021-08-21",
        "certification_date": "2021-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95016640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hannah Lee Chuapoco, M.S., LMFT
• Kevin Chung, DDS
• Autumn Patricia Clos, MD
• Cocoon Postpartum Doula Services
• William Brent Coffman, DDS
• Passion Zoey Coleman
• Diana Lizbeth Colon

• Nurse Practitioner in Yucaipa, CA
• Providers in Yucaipa, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.