Cherie Christine-Vivona Clark, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

21127 Issued in CA

Practice address

Eden Emergency Department
20103 Lake Chabot Road
Castro Valley, CA 94546

Phone

(510) 727-3320

Fax

(510) 727-2745

NPI assigned

Sep 15, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Cherie Christine Vivona Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: cvivona414388@hisp.ehr.sutterhealth.org

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.

• Bimc Faculty Practice

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1538351572

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1780992560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EDEN EMERGENCY DEPARTMENT",
            "address_2": "20103 LAKE CHABOT ROAD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "94546",
            "telephone_number": "510-727-3320",
            "fax_number": "510-727-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EDEN EMERGENCY DEPARTMENT",
            "address_2": "20103 LAKE CHABOT ROAD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "94546",
            "telephone_number": "510-727-3320",
            "fax_number": "510-727-2745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHERIE",
        "middle_name": "CHRISTINE-VIVONA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-15",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "21127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERIE",
            "last_name": "VIVONA",
            "middle_name": "CHRISTINE",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christopher a Walter DO Inc
• Olivia Chu, D.C.
• David Chuang
• Anita Chui, PHARM.D.
• Helena Chung, RD, MPH
• Corina Scheel Clark, P.A.
• Barry John Clements, PA-C
• Alondra Clemons
• Taylor Clines
• Abigail Ward Clinkscales, APRN, FNP-C

• Physician Assistant in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; 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.