Christopher Bernard Clark, REGISTERED NURSE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

551225 Issued in CA

Practice address

8971 Eureka Grove Cir
Granite Bay, CA 95746-6165

Phone

(229) 291-4618

NPI assigned

Mar 28, 2025

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1743120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1124821913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8971 EUREKA GROVE CIR",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957466165",
            "telephone_number": "229-291-4618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8971 EUREKA GROVE CIR",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957466165",
            "telephone_number": "229-291-4618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHRISTOPHER",
        "middle_name": "BERNARD",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-28",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "551225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Ray Chesebro, M.D.
• Brandon Neeley Christensen, D.M.D.
• Karina Jade Chu
• Christina Ciudad-Real
• Christa Lynn Clark, M.D.
• Colby Smith DDS, Inc
• Ashley Colen
• Megan Marie Combs
• Emmalee Compton
• Janet Christine Cookson, DPT

• Registered Nurse in Granite Bay, CA
• Providers in Granite Bay, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; 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.