Julie D Clark (NPI# 1346216389, PAC ID# 0345330494) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OBSTETRICS/GYNECOLOGY.
| Nation Provider ID (NPI) | 1346216389 |
| PAC ID by PECOS | 0345330494 |
| Professional Enrollment ID | I20071213000430 |
| Full Name | Julie D Clark |
| Organization Legal Name | ST JOSEPH HERITAGE HEALTHCARE |
| Address |
1550 Professional Dr Suite 100 Petaluma CA 94954-6655 |
| Phone Number | 7077632900 |
| Gender | F |
| Medical School | NEW YORK MEDICAL COLLEGE |
| Graduation Year | 2001 |
| Primary Specialty | OBSTETRICS/GYNECOLOGY |
| Group Practice PAC ID | 8921993205 |
| Number of Group Practice Members | 1049 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050174 | SANTA ROSA MEMORIAL HOSPITAL |
| 050136 | PETALUMA VALLEY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1179 N Mcdowell Blvd, Petaluma, CA 94954-6559 | 7075597500 | PETALUMA HEALTH CENTER INC |
| 1550 Professional Dr, Suite 100, Petaluma, CA 94954-6655 | 7077632900 | ST JOSEPH HERITAGE HEALTHCARE |
| 1165 Montgomery Dr, Santa Rosa, CA 95405-4801 | 7075463210 | ST JOSEPH HERITAGE HEALTHCARE |
| Organization Legal Name | ST JOSEPH HERITAGE HEALTHCARE |
| Physicians | 1022 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tarah N Nelson | Nurse Practitioner | St Joseph Heritage Healthcare | 2460 Buhne St, Eureka, CA 95501-3207 |
| Kristen Shay Rasnick | Nurse Practitioner | St Joseph Heritage Healthcare | 6580 Hembree Ln, Suite 270, Windsor, CA 95492-6885 |
| Basit Rahim | Neurology | St Joseph Heritage Healthcare | 26800 Crown Valley Pkwy, Suite 385, Mission Viejo, CA 92691-7320 |
| Elizabeth Wachtel O'brien | Certified Nurse Midwife (cnm) | St Joseph Heritage Healthcare | 3307 Renner Dr, Fortuna, CA 95540-3119 |
| Michael James Glamore | Urology | St Joseph Heritage Healthcare | 1701 4th St, Suite 200, Santa Rosa, CA 95404-3661 |
| Teresa E Shields-szabo | Family Medicine | St Joseph Heritage Healthcare | 26795 Portola Pkwy, Foothill Ranch, CA 92610-1713 |
| Austin James Perkins | Physician Assistant | St Joseph Heritage Healthcare | 100 E Valencia Mesa Dr, Suite 105, Fullerton, CA 92835-3816 |
| Sherin Ann Chakkalakel | Nurse Practitioner | St Joseph Heritage Healthcare | 905 E Washington St, St Joseph Heritage Healthcare, Petaluma, CA 94952-3389 |
| Jamie Lea Meyer | Nurse Practitioner | St Joseph Heritage Healthcare | 2332 23rd St, Eureka, CA 95501-3231 |
| Laura Elizabeth Hall | Nurse Practitioner | St Joseph Heritage Healthcare | 2280 Harrison Ave, Suite K, Eureka, CA 95501-3200 |
| Street Address |
1550 PROFESSIONAL DR SUITE 100 |
| City | PETALUMA |
| State | CA |
| Zip | 94954-6655 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anthony P Kosinski | Obstetrics/gynecology | St Joseph Heritage Healthcare | 1550 Professional Dr, Suite 100, Petaluma, CA 94954-6655 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ronald L Harris | Optometry | 1225 N Mcdowell Blvd, Petaluma, CA 94954-1112 | |
| Peter R Pretkel | Psychologist, Clinical | Psych Strategies Inc A Psychological Corp | 1301 Redwood Way, Suite 110, Petaluma, CA 94954-1136 |
| Julie L Restad | Chiropractic | 1301 Redwood Way, Suite 150, Petaluma, CA 94954-1136 | |
| Robert D Mosby | Psychologist, Clinical | Psych Strategies Inc A Psychological Corp | 1301 Redwood Way, Suite 110, Petaluma, CA 94954-1136 |
| Grace A Wakim | Psychologist, Clinical | Psych Strategies Inc A Psychological Corp | 1301 Redwood Way, Suite 110, Petaluma, CA 94954-1136 |
| Dan Lightfoot | Ophthalmology | Eye Care Institute A Medical Corporation | 1383 N Mcdowell Blvd, Suite 100, Petaluma, CA 94954-1190 |
| Kalane J Wong | Ophthalmology | Eye Care Institute A Medical Corporation | 1383 N Mcdowell Blvd, Suite 100, Petaluma, CA 94954-1190 |
| Robert L Anderson | Ophthalmology | Eye Care Institute A Medical Corporation | 1383 N Mcdowell Blvd, Suite 100, Petaluma, CA 94954-1190 |
| Robert A Harf | Orthopedic Surgery | 108 Lynch Creek Way, Suite 7, Petaluma, CA 94954-2310 | |
| Stephen M Gugenheim | Otolaryngology | St Joseph Heritage Healthcare | 108 Lynch Creek Way, Suite 7, Petaluma, CA 94954-2310 |
| Find all physicians in zip 94954 | |||
| City | PETALUMA |
| Zip Code | 94954 |
| Specialty | OBSTETRICS/GYNECOLOGY |
| City + Specialty | PETALUMA + OBSTETRICS/GYNECOLOGY |
Please comment or provide details below to improve the information on Julie D Clark.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.