Barbara Latrease Clark, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA19103 Issued in CA

Practice address

2401 Ridgeley
#4
Los Angeles, CA 90016

Phone

(323) 932-9646

Fax

(323) 932-9646

NPI assigned

Jan 8, 2008

Last updated

Nov 8, 2012By the provider in NPPES

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

Other identifiers 1

Other names 1

• Barbara Latrease Pearson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1285819318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 RIDGELEY",
            "address_2": "#4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90016",
            "telephone_number": "323-932-9646",
            "fax_number": "323-932-9646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 RIDGELEY",
            "address_2": "#4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90016",
            "telephone_number": "323-932-9646",
            "fax_number": "323-932-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "BARBARA",
        "middle_name": "LATREASE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-08",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA19103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD OF CA",
            "identifier": "PA19103",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BARBARA",
            "last_name": "PEARSON",
            "middle_name": "LATREASE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ahyana Clark
• Alicia Suzanne Clark, MPAP, PA-C
• Amara Candace Clark
• Andrew Clark, MD, PHD
• Anna Clark, M.A., CCC-SLP
• Bonnie Marie Clark
• Charae J Clark
• Cherise Clark, PHARMD
• Cherly Clark
• Chris Gordon Clark

• Medical Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; 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.