ANDREA CLARK (NPI# 1861937989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861937989 |
| Entity Type | Individual |
| Full Name | ANDREA CLARK |
| Credential | NP |
| Practice Address |
2201 South Ave South Lake Tahoe CA 96150-7025 |
| Mailing Address |
2715 21st St Sacramento CA 95818-3157 |
| Practice Telephone | 5305435623 |
| Enumeration Date | 2016-12-28 |
| Last Update Date | 2016-12-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
95004807 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982182309 | Andrea K Clark | Occupational Therapist | 920 Goldenrod Ln, Hickman, NE 68372-9509 | 2018-07-30 |
| 1407238660 | Andrea Clark | Contractor | 2300 Seaman St, Apt. 101, Toledo, OH 43605-1952 | 2015-06-24 |
| 1114359049 | Andrea Clark | Physical Therapist | 531 Madison St, Albany, CA 94706-1116 | 2013-08-02 |
| 1003124223 | Andrea Nicole Clark | Licensed Practical Nurse | 9869 State Route 141, Kitts Hill, OH 45645-8649 | 2010-09-22 |
| 1295057362 | Andrea Serina Clark | Speech-Language Pathologist | 7497 Oak Tree Ln, Spring Hill, FL 34607-2324 | 2010-02-17 |
| 1336369602 | Andrea Walser Clark | Counselor | 157 Walser Way, Advance, NC 27006-7341 | 2007-04-27 |
| 1912034596 | Andrea Rachele Clark | Psychologist | 1818 W Lindsey St Ste C120, Norman, OK 73069-4169 | 2007-02-28 |
| 1477593580 | Andrea Clark | Counselor | 120 W 57th St, 8th Floor, New York, NY 10019-3320 | 2006-06-07 |
| 1558999672 | Andrea Clark | Registered Nurse | 1155 Dairy Ashford Rd Ste 560, Houston, TX 77079-3035 | 2020-04-01 |
| 1306359948 | Andrea Clark | Counselor | 10 Southard St, Trenton, NJ 08609-1020 | 2017-11-06 |
| Street Address |
2201 SOUTH AVE |
| City | SOUTH LAKE TAHOE |
| State | CA |
| Zip Code | 96150-7025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710984075 | Jennifer Ann Ehmann | Pediatrics | 2201 South Ave, South Lake Tahoe, CA 96150-7025 | 2005-07-01 |
| 1477022358 | Drew N Herbert | Nurse Practitioner | 2201 South Ave, South Lake Tahoe, CA 96150-7025 | 2018-11-20 |
| 1417442419 | Sierra C Armstrong | Nurse Practitioner | 2201 South Ave, South Lake Tahoe, CA 96150-7025 | 2018-06-22 |
| 1902327992 | Laura Stevens | Social Worker | 2201 South Ave, South Lake Tahoe, CA 96150-7025 | 2017-06-29 |
| 1497202121 | Andrea Marie Baldwin | Nurse Practitioner | 2201 South Ave, South Lake Tahoe, CA 96150-7025 | 2016-09-11 |
| 1699187849 | Tessa Dahlen Amos | Nurse Practitioner | 2201 South Ave, South Lake Tahoe, CA 96150-7025 | 2014-05-22 |
| 1134558000 | Jacquelyn Noel Sartorius | Physician Assistant | 2201 South Ave, South Lake Tahoe, CA 96150-7025 | 2013-11-01 |
| 1548607955 | Brooke M Pancio | Family Medicine | 2201 South Ave, South Lake Tahoe, CA 96150 | 2013-05-24 |
| 1063856094 | Danielle Marie Priem | Pediatrics | 2201 South Ave, South Lake Tahoe, CA 96150-7025 | 2013-04-22 |
| 1558600122 | Elke Anne Houser | Nurse Practitioner | 2201 South Ave, South Lake Tahoe, CA 96150-7025 | 2013-02-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750818969 | Terri Wong | Behavior Technician | 908 Alameda Ave, #b, South Lake Tahoe, CA 96150 | 2017-05-18 |
| 1154735157 | Catherine Anne Jones | Dental Hygienist | 1088 4th St # 6, South Lake Tahoe, CA 96150 | 2014-06-17 |
| 1245663194 | Sheila Marie Gwin | Behavioral Analyst | 2111south Ave, South Lake Tahoe, CA 96150 | 2013-08-14 |
| 1164785598 | Launa Jean Martin | Doula | 1399 Bozeman Dr, South Lake Tahoe, CA 96150 | 2012-06-20 |
| 1881957355 | Elizabeth Marilyn Mcnamara | Emergency Medicine | Barton Memorial Hospital, 2107 South Ave, South Lake Tahoe, CA 96150 | 2012-06-20 |
| 1295034627 | Dana Elizabeth Cox | Chiropractor | 3097 Harrison Ave., # 202, S. Lake Tahoe, CA 96150 | 2011-03-24 |
| 1639485162 | April Lyn Westfall | Dentist | 3358 Sandy Way, # B, S Lake Tahoe, CA 96150 | 2010-08-21 |
| 1700199270 | Rollie E Rohnow | Pharmacist | 1020 Al Tahoe Blvd, Rite Aid Pharmacy, South Lake Tahoe, CA 96150 | 2010-07-26 |
| 1699000455 | Ellen Newell Mccullough | Physical Therapist | 1900 High Meadow Trail, South Lake Tahoe, CA 96150 | 2009-10-13 |
| 1093941148 | Ashley Elizabeth Bedell | Counselor | 1137 Emerald Bay Rd., South Lake Tahoe, CA 96150 | 2009-06-03 |
| Find all providers in zip 96150 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750920559 | Young Soon Keum | Nurse Practitioner | 1108 4th St, South Lake Tahoe, CA 96150-3476 | 2019-12-27 |
| 1477022358 | Drew N Herbert | Nurse Practitioner | 2201 South Ave, South Lake Tahoe, CA 96150-7025 | 2018-11-20 |
| 1497202121 | Andrea Marie Baldwin | Nurse Practitioner | 2201 South Ave, South Lake Tahoe, CA 96150-7025 | 2016-09-11 |
| 1699187849 | Tessa Dahlen Amos | Nurse Practitioner | 2201 South Ave, South Lake Tahoe, CA 96150-7025 | 2014-05-22 |
| 1558600122 | Elke Anne Houser | Nurse Practitioner | 2201 South Ave, South Lake Tahoe, CA 96150-7025 | 2013-02-02 |
| 1124238548 | Patience Wenck | Nurse Practitioner | 1154 Emerald Bay Rd, South Lake Tahoe, CA 96150-6288 | 2007-05-23 |
| 1013907096 | Amy Pittlick Smith | Nurse Practitioner | 2170 South Ave, South Lake Tahoe, CA 96150-7026 | 2005-10-21 |
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|---|---|---|---|---|
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| 1861093601 | Philana P Mcdonald | Nurse Practitioner | 183 Stonebridge Ln, Paso Robles, CA 93446-1926 | 2020-11-06 |
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| 1073114096 | Blanca De Jesus Serrano | Nurse Practitioner | 18144 Outer Hwy 18 Ste 200, Apple Valley, CA 92307-2212 | 2020-11-05 |
| 1578164166 | Aimon Sangwanpanich | Nurse Practitioner | 8520 Shirley Ave, Northridge, CA 91324-4149 | 2020-11-02 |
| 1043810757 | Casie Lee Mcguire | Nurse Practitioner | 1826 Rainbow Terrace Ln, Montebello, CA 90640-1953 | 2020-10-30 |
| 1295335099 | Jail Lopez | Nurse Practitioner | 3171 Lynwood Rd, Lynwood, CA 90262-4118 | 2020-10-29 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH LAKE TAHOE |
| Zip Code | 96150 |
Please comment or provide details below to improve the information on ANDREA CLARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.