Christina Macdonald Fraser Clark, MSN.FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

C367540 Issued in CA

Practice address

330 Ellis St
Glide Health Services
San Francisco, CA 94102-2735

Phone

(415) 674-6130

Fax

(415) 673-1037

NPI assigned

Mar 2, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336089600000",
    "number": "1861520504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 TAMALPAIS DR",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412659",
            "telephone_number": "415-381-4735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 ELLIS ST",
            "address_2": "GLIDE HEALTH SERVICES",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941022735",
            "telephone_number": "415-674-6130",
            "fax_number": "415-673-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHRISTINA",
        "middle_name": "MACDONALD FRASER",
        "name_prefix": "Ms.",
        "credential": "MSN.FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2012-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "C367540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Clark
• Brian Larence Clark, HEALTH WORKER
• Caitlin M. Clark, MD
• Carol A Clark, MSPT
• Christen Elizabeth Clark, RN
• Corey Clark
• Cynthia Lynne Clark, M.D.
• David Clark, CMT
• Edith Clark
• Eric Deon Clark, SUDCC

• Family Nurse Practitioner in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; 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.