DONNA M CLARK GNP
NPI 1104832617
Nurse Practitioner - Gerontology in Vista, CA

Q: What is Donna Clark's NPI number?

The NPI number for Donna Clark is 1104832617. It was assigned to this individual provider in the NPPES registry on August 1, 2006.

Q: What is Donna Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Donna Clark was last updated on August 2, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 01, 2006

130 CEDAR RD STE 200, VISTA, CA 92083(760) 806-5620(760) 806-5639 Get Directions Write a Review

NPPES record last updated: August 2, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Donna M Clark Gnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DONNA M CLARK GNP (NPI 1104832617) is an individual gerontology provider in Vista, California, licensed in California (6328) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1104832617

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameDONNA M CLARKCredential: GNP

Location Address130 CEDAR RD STE 200Vista, CA 92083-5102

Mailing Address10170 Sorrento Valley RdSan Diego, CA 92121-1604 · (858) 784-5888

Phone(760) 806-5620

Fax(760) 806-5639

Sole ProprietorNo

Enumeration DateAugust 1, 2006

Last NPPES UpdateAugust 2, 2013

✔ NPI 1104832617 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in CA · 6328

Also ListedRegistered NurseTaxonomy 163W00000X · License RN485608 (CA)

Also ListedRegistered Nurse · Diabetes EducatorTaxonomy 163WD0400X · License RN485608 (CA)

Also ListedRegistered Nurse · GerontologyTaxonomy 163WG0600X · License RN485608 (CA)

130 CEDAR RD STE 200, Vista, CA 92083

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Other Identifiers 3

Medicare ID-Type UnspecifiedWNP6328ACA

MedicaidRN485608CA

Medicare UPINP09312CA

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Donna Clark's NPI number?

The NPI number for Donna Clark is 1104832617. It was assigned to this individual provider in the NPPES registry on August 1, 2006.

Where is Donna Clark located?

Donna Clark practices at 130 Cedar Rd Ste 200, Vista, CA 92083. The listed phone number is (760) 806-5620.

What is Donna Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

When was this NPI record last updated?

The NPPES record for Donna Clark was last updated on August 2, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.