DR. JUANETTE G CLARK (NPI# 1326572132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1326572132 |
Entity Type | Individual |
Full Name | DR. JUANETTE G CLARK |
Other Name | DR. JUANETTE CLARK |
Credential | FNP |
Practice Address |
27168 Newport Rd Suite 1 Menifee CA 92584-7383 |
Mailing Address |
683 Lomas Santa Fe Dr Solana Beach CA 92075-1412 |
Practice Telephone | 9512463033 |
Practice Fax Number | 9512467373 |
Mailing Telephone | 8587556697 |
Enumeration Date | 2017-04-18 |
Last Update Date | 2020-08-04 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
95002760 | CA | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
27168 NEWPORT RD SUITE 1 |
City | MENIFEE |
State | CA |
Zip Code | 92584-7383 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376735688 | Mariam Dehyar | Family Medicine | 27168 Newport Rd, Suite 1, Menifee, CA 92584-7383 | 2007-08-10 |
1881945038 | Menifee Valley Optometry PC | Optometrist | 27168 Newport Rd, Suite 4, Menifee, CA 92584-7383 | 2012-09-27 |
1649599085 | Beverly Radiology Medical Group | Radiology | 27168 Newport Rd, Suite B, Menifee, CA 92584-7383 | 2010-05-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467091249 | Christopher Aron Sanders | Family Medicine | 30243 Westlake Dr, Menifee, CA 92584 | 2019-12-27 |
1336619451 | Tricia Rose Fontanilla Alegado | Nurse Practitioner | 29740 Mesa Verde Cir, Menifee, CA 92584 | 2018-12-01 |
1548776446 | Nicole O'neil | Nurse Practitioner | 29826 Haun Rd Suite 300, Menifee, CA 92584 | 2017-12-14 |
1518485150 | Harvinder Singh | Driver | 31972 Ruxton St, Menifee, CA 92584 | 2017-09-04 |
1558884239 | Poulsen Dental Corporation | Dentist | 29121 Newport Road, Ste 1, Menifee, CA 92584 | 2017-07-25 |
1598200040 | Thay Kieu | Dental Hygienist | 30035 Haun Rd, Menifee, CA 92584 | 2016-12-19 |
1033668652 | Thrifty Payless Inc | Durable Medical Equipment & Medical Supplies | 28995 Newport Road, Menifee, CA 92584 | 2016-09-23 |
1295187474 | Cohen Sedgh, Manavi & Pakravan Dental Corp | Dentist | 30035 Haun Road, Menifee, CA 92584 | 2016-07-12 |
1871965640 | Sharon D. Benjamin | Licensed Vocational Nurse | 29120 Bridgeport Lane, Menifee, CA 92584 | 2015-10-20 |
1538573175 | Edwin Haroldo Alvarez | Physician Assistant | 31216 Silver Moon Court, Menifee, CA 92584 | 2014-06-11 |
Find all providers in zip 92584 |
Taxonomy Code | 363LP2300X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548776446 | Nicole O'neil | Nurse Practitioner | 29826 Haun Rd Suite 300, Menifee, CA 92584 | 2017-12-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235738782 | Peninsula Healthcare Center | Nurse Practitioner | 22330 Hawthorne Blvd Ste 208, Torrance, CA 90505-2536 | 2020-10-25 |
1710584008 | Venessa Beck | Nurse Practitioner | 903 Cardiff St, San Diego, CA 92114-5019 | 2020-10-08 |
1053918094 | Janel Nicole Sanglerat | Nurse Practitioner | 416 Aviation Blvd, Santa Rosa, CA 95403-1032 | 2020-10-02 |
1790382760 | Christopher Tran | Nurse Practitioner | 11441 Heacock St Ste F, Moreno Valley, CA 92557-7907 | 2020-10-02 |
1487266292 | Mollie Shira Hudson | Nurse Practitioner | 14 Whitmore Pl Apt 15, Oakland, CA 94611-4635 | 2020-08-21 |
1962014381 | Mario Javier Herrera | Nurse Practitioner | 2130 High Pointe Dr, Apt 108, Corona, CA 92879 | 2020-08-18 |
1952912131 | Norman Ivan Kier | Nurse Practitioner | 3834 Edison Ave, Sacramento, CA 95821-2728 | 2020-08-12 |
1942811377 | Thanhan Mathews | Nurse Practitioner | 114 W Cameron St Apt B, Hanford, CA 93230-2965 | 2020-08-10 |
1972113355 | Marine Mary Kademyan | Nurse Practitioner | 6528 Babcock Ave, North Hollywood, CA 91606 | 2020-07-31 |
1245849645 | Shannon Pereira | Nurse Practitioner | 2368 Honeysuckle Way, Hemet, CA 92545-4796 | 2020-07-31 |
Find all providers with the same taxonomy |
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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.