Amy J. Clark, RN, IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

11270710 Issued in CA

Practice address

731 18TH Ave
San Francisco, CA 94121-3824

Phone

(415) 254-5349

NPI assigned

Nov 16, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1386988194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 18TH AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941213824",
            "telephone_number": "415-254-5349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 18TH AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941213824",
            "telephone_number": "415-254-5349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "AMY",
        "middle_name": "J.",
        "credential": "RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-16",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "520681",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "CA",
            "license": "11270710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Giselle Clark-Ibanez, LCSW
• Ian Winston Clark-Johnson
• Jeanine Rhea Clark-Kent, RN
• Aaron Clark, MD, PHD
• Adrienne Lange Clark, MD
• Angel Lea Clark, L.AC.
• Anna Clark, LMFT
• Bradley Clark, DDS
• Brandon Clark
• Brian Larence Clark, HEALTH WORKER

• Lactation Consultant (Registered Nurse) in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Lactation Consultant (Registered Nurse) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.