Active NPI
Victoria Clark
- Adult Psychiatric/Mental Health Registered Nurse
- Escondido, CA
National Provider Identifier
1568924082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Psychiatric/Mental Health Registered Nurse
- License
- RN95089079
- Practice address
- 125 W Mission Ave
Escondido, CA 92025-1720 - Phone
- (760) 747-3424
- Fax
- (760) 747-3435
- NPI assigned
- Apr 3, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Psychiatric/Mental Health Registered Nurse | 163WP0809X | RN95089079 | CA | Primary |
Addresses
Primary practice location
125 W Mission Ave
Escondido, CA 92025-1720
Mailing address
125 W Mission Ave
Escondido, CA 92025-1720
Phone (760) 747-3424
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 |
|---|---|---|---|
| RN95089079 | CA | MD | Adult Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554249600000",
"number": "1568924082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 W MISSION AVE",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920251720",
"telephone_number": "760-747-3424",
"fax_number": "760-747-3435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 W MISSION AVE",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920251720",
"telephone_number": "760-747-3424",
"fax_number": "760-747-3435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "VICTORIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-03",
"last_updated": "2019-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0809X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
"state": "CA",
"license": "RN95089079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Escondido, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.