Active NPI
Cynthia Rae Clark, F.N.P.
- Pediatric Nurse Practitioner
- Vista, CA
National Provider Identifier
1679698849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- NP16833
- Practice address
- 1000 Vale Terrace Dr
Vista, CA 92084-5218 - Phone
- (760) 631-5000
- NPI assigned
- Mar 20, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | NP16833 | CA | Primary |
| Family Nurse Practitioner | 363LF0000X | NP16833 | CA | |
| Pediatric Registered Nurse | 163WP0200X | RN575767 | CA |
Addresses
Primary practice location
1000 Vale Terrace Dr
Vista, CA 92084-5218
Mailing address
3860 Calle Fortunada
Suite 210
San Diego, CA 92123-4800
Phone (858) 309-6300
Other names 1
- Cynthia Rae Wheeler
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130612000294 | CA | Order and Referring Only - Nurse Practitioner | 9335388990 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN575767 | CA | MD | Pediatric Registered Nurse |
| NP16833 | CA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vista Community Clinic | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- cynthia.clarknp.p1@direct.vistacommunityclinic.nextgenshare.com
Organizations & group practices 1
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.
-
- Federally Qualified Health Center (FQHC)
- Oceanside, CA
- NPI 1649363375
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780012800000",
"number": "1679698849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3860 CALLE FORTUNADA",
"address_2": "SUITE 210",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234800",
"telephone_number": "858-309-6300",
"fax_number": "858-309-6301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 VALE TERRACE DR",
"city": "VISTA",
"state": "CA",
"postal_code": "920845218",
"telephone_number": "760-631-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "CYNTHIA",
"middle_name": "RAE",
"credential": "F.N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2026-05-29",
"certification_date": "2026-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CA",
"license": "NP16833",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "NP16833",
"primary": false
},
{
"code": "163WP0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Pediatrics",
"state": "CA",
"license": "RN575767",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CYNTHIA",
"last_name": "WHEELER",
"middle_name": "RAE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.