DESIREE DEON CLARK (NPI# 1144861451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144861451 |
| Entity Type | Individual |
| Full Name | DESIREE DEON CLARK |
| Credential | PA-C |
| Practice Address |
9600 S 1300 E Ste 240 Sandy UT 84094-3783 |
| Mailing Address |
7181 S Campus View Dr West Jordan UT 84084-4312 |
| Practice Telephone | 8019653600 |
| Mailing Telephone | 8019653505 |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2019-10-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 9507169-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | STATE LICENSE | 9507169-1206 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750932349 | Desiree Imani Clark | Behavioral Analyst | 3186 Airway Ave Ste A, Costa Mesa, CA 92626-4650 | 2019-09-25 |
| Street Address |
9600 S 1300 E STE 240 |
| City | SANDY |
| State | UT |
| Zip Code | 84094-3783 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649754508 | Hollie J Wharton | Advanced Practice Midwife | 9450 S. 1300 E., Sandy, UT 84094 | 2018-09-18 |
| 1417306804 | Sarah Scheibe | Counselor | 1123 E Tulane Cir, Sandy, UT 84094 | 2016-06-07 |
| 1457771313 | Zhenhao Liu | Internal Medicine | 11333 S 1000 E Ste 100, Sandy, UT 84094 | 2014-04-18 |
| 1770919714 | Bojan Jurosevic | Physical Therapist | 7940 South 1300 East, Sandy, UT 84094 | 2013-09-23 |
| 1104259464 | Ryan Blick | Marriage & Family Therapist | 833 East 9400 South, Sandy, UT 84094 | 2013-08-09 |
| 1780027821 | Lauren Coyle | Obstetrics & Gynecology | 9600 S 1300 E Ste 308, Sandy, UT 84094 | 2013-04-08 |
| 1285971697 | Robert W Later Md PC | Specialist | 9600 S 1300 E Suite 302, Sandy, UT 84094 | 2013-01-07 |
| 1306149679 | Premier Home Health, LLC | Home Health | 978 Larkspur Dr, Sandy, UT 84094 | 2010-12-08 |
| 1760704753 | Altaview Hospital | General Acute Care Hospital | 9660 South 13th East, Sandy, UT 84094 | 2010-02-18 |
| 1750518676 | Julie Christensen | Social Worker | 833 E 9400 S, Sandy, UT 84094 | 2009-06-18 |
| Find all providers in zip 84094 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861047201 | Shelbi Brooke Fletcher | Physician Assistant | 2034 E Tall Pines Way, Sandy, UT 84092-5285 | 2019-08-02 |
| 1295241990 | Corbin N Rasmussen | Physician Assistant | 1666 E Paulista Way, Sandy, UT 84093-6724 | 2017-12-18 |
| 1023411592 | Wei Ting Chao | Physician Assistant | 385 W 9000 S, Sandy, UT 84070-2551 | 2014-09-29 |
| 1801194097 | Tracy Lynn Holley | Physician Assistant | 9844 S 1300 E Ste 100, Sandy, UT 84094-4600 | 2011-03-11 |
| 1174797757 | Gordon Lynn Day | Physician Assistant | 9665 S 1835 E, Sandy, UT 84092-3072 | 2008-04-15 |
| 1992992952 | Terri Hopkins Clawson | Physician Assistant | 11333 S 1000 E Ste 102, Sandy, UT 84094-5421 | 2007-10-03 |
| 1508378431 | Amber Dawn Wright | Physician Assistant | 9140 S State St Ste 101, Sandy, UT 84070-2694 | 2017-11-01 |
| 1417467135 | Christine Weaver | Physician Assistant | 1393 E Sego Lily Dr, Sandy, UT 84092-4350 | 2017-10-08 |
| 1750891552 | Teran Mccormick | Physician Assistant | 9450 S 1300 E, Sandy, UT 84094-5555 | 2017-10-05 |
| 1730555236 | Brittania Cogan | Physician Assistant | 9844 S 1300 E Ste 100, Sandy, UT 84094-4600 | 2015-08-19 |
| Find all providers in SANDY | ||||
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| 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.