Active NPI
Alia Kehaulani Clark
- Midwife
- San Luis Obispo, CA
National Provider Identifier
1295222792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 533
- Practice address
- 1135 Marsh St
San Luis Obispo, CA 93401-3323 - Phone
- (805) 465-9847
- Fax
- (805) 666-1029
- NPI assigned
- Apr 19, 2018
- Last updated
- Jul 17, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Non-RN) | 174N00000X | L-318699 | CA | |
| Midwife | 176B00000X | 533 | CA | Primary |
Addresses
Primary practice location
1135 Marsh St
San Luis Obispo, CA 93401-3323
Mailing address
1135 Marsh St
San Luis Obispo, CA 93401-3323
Phone (805) 465-9847
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 533 | Other | CA | LICENSED MIDWIFE |
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 |
|---|---|---|---|
| L-318699 | CA | MD | Lactation Consultant (Non-RN) |
| 533 | CA | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752710400000",
"number": "1295222792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1135 MARSH ST",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934013323",
"telephone_number": "805-465-9847",
"fax_number": "805-666-1029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1135 MARSH ST",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934013323",
"telephone_number": "805-465-9847",
"fax_number": "805-666-1029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "ALIA",
"middle_name": "KEHAULANI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-19",
"last_updated": "2025-07-17",
"certification_date": "2025-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "174N00000X",
"taxonomy_group": "",
"desc": "Lactation Consultant, Non-RN",
"state": "CA",
"license": "L-318699",
"primary": false
},
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "CA",
"license": "533",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED MIDWIFE",
"identifier": "533",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.