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NPI 1306587183

NPI 1306587183 : ALANA CLARK NP : RICHMOND, CA

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General NPI Number Information
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    NPI Number           |    1306587183
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    Entity Type          |    Individual 
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    Provider Name        |    ALANA CLARK NP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/05/2022
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    Last Update Date     |    04/05/2022
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Provider Practice Location Address
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    Address Line         |    150 HARBOUR WAY 
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    City                 |    RICHMOND
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    State                |    CA
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    Zip                  |    94801-3554
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    Country              |    US
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    Telephone            |    510-981-4100
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    42 GREENBANK AVE 
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    City                 |    PIEDMONT
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    State                |    CA
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    Zip                  |    94611-4334
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    Country              |    US
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    Telephone            |    510-579-2438
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LA2200X
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    Taxonomy Name        |    Adult Health Nurse Practitioner
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    License Number       |    95018487
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    License Number State |    CA
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Taxonomy #2
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    Taxonomy Code        |    363LG0600X
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    Taxonomy Name        |    Gerontology Nurse Practitioner
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    License Number       |    95018487
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    License Number State |    CA
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Taxonomy #3
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    Taxonomy Code        |    363LP2300X
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    Taxonomy Name        |    Primary Care Nurse Practitioner
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    License Number       |    95018487
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    License Number State |    CA
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