Individual provider Active NPI

Clara Werner Dougherty, PA-C

  • Medical Physician Assistant
  • La Jolla, CA
National Provider Identifier
1609987619
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA17439 Issued in CA
Practice address
9850 Genesee Ave
Suite 400
La Jolla, CA 92037-1224
Phone
(858) 453-5944
Fax
(858) 429-7925
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA17439 CA Primary

Addresses

Primary practice location

9850 Genesee Ave
Suite 400
La Jolla, CA 92037-1224

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (760) 704-5730

Other practice location 1

2205 Vista Way
Oceanside, CA 92054-5661
Phone (760) 704-5730

Other names 1

  • Ms. Clara Werner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041019000565 CA Practitioner - Physician Assistant 6406817998 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
R Franklin University of Med & Sci/Chicago Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

2205 Vista Way
Oceanside, CA 92054-5661

354 Santa Fe Dr
Encinitas, CA 92024-5142
Phone (760) 633-6501

9888 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9896 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9898 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 455-9100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA17439CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Nov 27, 2023 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Nov 27, 2023 Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

320 Santa Fe Dr
Ste 108
Encinitas, CA 92024
Phone (760) 436-4558

9850 Genesee Ave
Ste 440
La Jolla, CA 92037
Phone (858) 453-5944

9850 Genesee Ave
Ste 400
La Jolla, CA 92037
Phone (858) 558-8666

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

2205 Vista Way
Ste 220
Oceanside, CA 92054

2205 Vista Way
Oceanside, CA 92054
Phone (760) 704-5400

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

3444 Kearny Villa Rd
Ste 202
San Diego, CA 92123
Phone (858) 429-7646

Interoperability endpoints

  • Direct secure messaging: claradougherty@ghp.allscriptsdirect.net
  • Direct secure messaging: clara.dougherty.1@3663.direct.athenahealth.com
  • Direct secure messaging: cdougherty42076@scrippshlth.medalliesdirect.net

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1609987619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "760-704-5730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE",
            "address_2": "SUITE 400",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371224",
            "telephone_number": "858-453-5944",
            "fax_number": "858-429-7925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2205 Vista Way",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "CA",
            "postal_code": "920545661",
            "country_code": "US",
            "telephone_number": "760-704-5730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "CLARA",
        "middle_name": "WERNER",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA17439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLARA",
            "last_name": "WERNER",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.