JENNIFER M. CLARK (NPI# 1437335551) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437335551 |
| Entity Type | Individual |
| Full Name | JENNIFER M. CLARK |
| Credential | R.N., FNP |
| Practice Address |
500 Doyle Park Dr Ste G04 Santa Rosa CA 95405-4559 |
| Practice Telephone | (707) 303-8349 |
| Practice Fax Number | 7073032694 |
| Mailing Telephone | (707) 303-8349 |
| Mailing Fax Number | 7073032694 |
| Enumeration Date | 2008-01-18 |
| Last Update Date | 2017-06-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | NP12069 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 740722 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS | 8Y5099 | 01 |
| TX | 193487901 | 05 | |
| TX | RR MEDICARE | P00622287 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932723038 | Jennifer Michelle Clark | Social Worker | 22 Norva Ave, Frederick, MD 21701-6279 | 2020-06-04 |
| 1982249926 | Jennifer Rae Clark | Nurse Practitioner | 2800 E League City Pkwy Apt 216, League City, TX 77573-1676 | 2019-11-13 |
| 1528546827 | Jennifer Clark | Technician | 59 Forrester St Sw Apt B, Washington, DC 20032-2120 | 2018-07-30 |
| 1265940340 | Jennifer Anne Clark | Counselor | 35 Pulaski Rd, Whitehouse Station, NJ 08889-3516 | 2018-01-11 |
| 1598118572 | Jennifer Clark | Internal Medicine | 1120 W. Michigan Street Gatch Hall Cl 630, Indianapolis, IN 46204 | 2016-07-14 |
| 1295124899 | Jennifer Clark | Behavioral Analyst | 662 Lake George Dr, Melbourne, FL 32940-2221 | 2015-01-20 |
| 1851707194 | Jennifer Sara Clark | Physical Therapist | 797 Evergreen Dr, West Hempstead, NY 11552-3406 | 2014-07-08 |
| 1083988794 | Jennifer Makiki Clark | Health Educator | 5858 Wilshire Blvd Ste 300, Los Angeles, CA 90036-4509 | 2012-02-27 |
| 1639484520 | Jennifer Ann Clark | Speech-Language Pathologist | 5903 Neptune Dr, Fort Collins, CO 80525-3905 | 2010-08-16 |
| 1245567247 | Jennifer Selleck Clark | Nurse Practitioner | 1840 Martin Luther King Jr Blvd Ste C4, Chapel Hill, NC 27514 | 2009-11-11 |
| Street Address |
500 DOYLE PARK DR STE G04 |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95405-4559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316162662 | Mark A Covec | Nurse Practitioner | 500 Doyle Park Dr Ste G04, Santa Rosa, CA 95405-4559 | 2007-04-13 |
| 1942692025 | Jeannie Zanetti | Nurse Practitioner | 500 Doyle Park Dr Ste G04, Santa Rosa, CA 95405-4559 | 2015-02-26 |
| 1487916045 | Austin Sue | Family Medicine | 500 Doyle Park Dr Ste G04, Santa Rosa, CA 95405 | 2012-06-11 |
| 1639382070 | Santa Rosa Ob-gyn Medical Associates Group | Obstetrics & Gynecology | 500 Doyle Park Dr Ste G04, Santa Rosa, CA 95405-4559 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230486 | Lizett Camacho | Counselor | 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 | 2020-06-22 |
| 1346768918 | Ingrid Tsong | Student in an Organized Health Care Education/Training Program | 3447 Summerfield Road, Santa Rosa, CA 95405 | 2017-09-05 |
| 1275051898 | Jessica Peters Malmberg | Student in an Organized Health Care Education/Training Program | 2447 Summerfield Rd, Santa Rosa, CA 95405 | 2017-09-04 |
| 1306246772 | Kirsten Eckert | Advanced Practice Midwife | 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 | 2014-09-03 |
| 1982034294 | Mohammad Reza Saeidi | Dentist | 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 | 2013-11-22 |
| 1851631642 | Debi M. Emmons | Marriage & Family Therapist | 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 | 2013-02-15 |
| 1841549979 | Karie Louise Klim | Marriage & Family Therapist | 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 | 2012-09-05 |
| 1427314400 | Rachel E. Page | Counselor | 2447 Summerfield Rd., Santa Rosa, CA 95405 | 2012-04-04 |
| 1689991572 | Center for Integral Healing Inc. | Community Health Worker | 182 Farmers Lane, #203, Santa Rosa, CA 95405 | 2010-04-30 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| Find all providers in zip 95405 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427518596 | Jeannine Anne Freeman | Nurse Practitioner | 1936 Northfield Dr, Santa Rosa, CA 95403-2086 | 2019-03-23 |
| 1215449814 | Jinney Murdes | Nurse Practitioner | 70 Stony Point Rd Ste G, Santa Rosa, CA 95401-4492 | 2017-11-04 |
| 1982121885 | Jennifer Elizabeth Warren | Nurse Practitioner | 1144 Sonoma Ave Ste 119, Santa Rosa, CA 95405-4812 | 2017-08-23 |
| 1205245255 | Jacqueline Anderson | Nurse Practitioner | 2057 Northfield Dr, Santa Rosa, CA 95403-2073 | 2014-08-04 |
| 1679792071 | Jane E Kennedy | Nurse Practitioner | 2455 Bennett Valley Rd Ste B205, Santa Rosa, CA 95404-5667 | 2007-04-24 |
| 1619903010 | James Clifford Strother | Nurse Practitioner | 3536 Mendocino Avenue, #300, Santa Rosa, CA 95403 | 2006-06-25 |
| 1720052921 | Dana K Mckinney | Nurse Practitioner | 2023 Gardenview Pl, Santa Rosa, CA 95403-9488 | 2006-02-14 |
| 1770553273 | Jennifer Carin Follestad | Nurse Practitioner | 392 Tesconi Ct, Santa Rosa, CA 95401-4653 | 2006-01-25 |
| 1508403551 | Victoria Ojiako | Nurse Practitioner | 2235 Challenger Way, Santa Rosa, CA 95407-5458 | 2019-12-09 |
| 1548723422 | Sunny Bush | Nurse Practitioner | 480 Tesconi Cir Ste B, Santa Rosa, CA 95401-4691 | 2019-04-09 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95405 |
Please comment or provide details below to improve the information on JENNIFER M. 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.