Antonia Malia Clark

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

95191828 Issued in CA

Practice address

7901 Frost St
San Diego, CA 92123-2701

Phone

(858) 939-3400

NPI assigned

Apr 28, 2023

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1682640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1285322016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 MANZANITA DR",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920575405",
            "telephone_number": "619-621-9545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 FROST ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232701",
            "telephone_number": "858-939-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ANTONIA",
        "middle_name": "MALIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-28",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "95191828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan E Clark, ALAN CLARK
• Alana Sandra Clark
• Amy R Clark, APRN, NP
• Ann D Clark, MFT
• Anthony Clark
• Ashley Lin Clark, M.D.
• Ashley Nicole Clark
• Ashley T Clark
• Brianna Yvonne Clark, ND, MS
• Brittany Brashantia Clark, NP

• Community Health Registered Nurse in San Diego, CA
• Providers in San Diego, CA by specialty
• Community Health Registered Nurse in California

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

Verify at the official NPI Registry.