Active NPI
Dashanae Clark
- Licensed Vocational Nurse
- Los Angeles, CA
National Provider Identifier
1194426478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 731651
- Practice address
- 1774 Zonal Ave BLDG B
Los Angeles, CA 90033-1064 - Phone
- (310) 221-6336
- NPI assigned
- Mar 14, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 731651 | CA | Primary |
Addresses
Primary practice location
1774 Zonal Ave BLDG B
Los Angeles, CA 90033-1064
Mailing address
1774 Zonal Ave BLDG B
Los Angeles, CA 90033-1064
Phone (310) 221-6336
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 731651 | CA | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678752000000",
"number": "1194426478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1774 ZONAL AVE BLDG B",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331064",
"telephone_number": "310-221-6336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1774 ZONAL AVE BLDG B",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331064",
"telephone_number": "310-221-6336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "DASHANAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-14",
"last_updated": "2023-03-14",
"certification_date": "2023-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "731651",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.