Rebecca Clark, RN, MSN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

95102199 Issued in CA

Practice address

39350 Gallaudet Dr
Fremont, CA 94538-2308

Phone

(510) 794-3747

NPI assigned

Mar 28, 2024

Last updated

Mar 28, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1447001367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5643 MILES AVE APT 2",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181787",
            "telephone_number": "305-498-6624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39350 GALLAUDET DR",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382308",
            "telephone_number": "510-794-3747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "REBECCA",
        "name_prefix": "Ms.",
        "credential": "RN, MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95102199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Civic Medical Center, Inc.
• CKS Medical Group Inc.
• Beverly Claiborne, DDS
• April Clark
• Marques Demont Clark
• William L Clauson, M.D.
• Martha Clemente
• William Christopher Cliff, DDS, MSD
• Brejonne Clinton
• Mary M. Co-Asino, MD

• Registered Nurse in Fremont, CA
• Providers in Fremont, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.