KELLIE CLARK
NPI 1356962138
Licensed Vocational Nurse in San Diego, CA

Active since May 02, 2020
734 10TH AVE, SAN DIEGO, CA 92101(619) 239-4663 Get Directions Write a Review

NPPES record last updated: May 2, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kellie Clark NPPES

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

KELLIE CLARK (NPI 1356962138) is an individual licensed vocational nurse in San Diego, California, licensed in California (209282) and active in the NPI registry since May 2020.

NPPES Registry Identity

NPI1356962138
Entity TypeIndividualFemale
Primary Taxonomy164X00000X
Provider Legal NameKELLIE CLARK
Location Address734 10TH AVESan Diego, CA 92101-6502
Mailing Address734 10th AveSan Diego, CA 92101-6502 · (619) 239-4663
Sole ProprietorNo
Enumeration DateMay 2, 2020
NPPES CertifiedMay 2, 2020
NPI 1356962138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyLicensed Vocational NurseNursing Service Providers
Taxonomy Code164X00000X
License Licensed in CA · 209282
Definition

A licensed vocational nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. [An alternate term for licensed practical nurse arising from difference in occupational titles between states and post-high school training programs and institutions.] Requirements for education, experience, licensure, and job responsibilities vary among the states.

734 10TH AVE, San Diego, CA 92101

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
734 10TH AVE
SAN DIEGO, CA 92101
Registered Nurse (Psychiatric/Mental Health, Adult)
734 10TH AVE
SAN DIEGO, CA 92101
Marriage & Family Therapist
734 10TH AVE
SAN DIEGO, CA 92101
Counselor (Mental Health)
734 10TH AVE
SAN DIEGO, CA 92101
Licensed Vocational Nurse
734 10TH AVE
SAN DIEGO, CA 92101
Counselor (Mental Health)
734 10TH AVE
SAN DIEGO, CA 92101
Licensed Vocational Nurse
734 10TH AVE
SAN DIEGO, CA 92101
Registered Nurse
734 10TH AVE
SAN DIEGO, CA 92101

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 Kellie Clark's NPI number?

The NPI number for Kellie Clark is 1356962138. It was assigned to this individual provider in the NPPES registry on May 2, 2020.

Where is Kellie Clark located?

Kellie Clark practices at 734 10th Ave, San Diego, CA 92101. The listed phone number is (619) 239-4663.

What is Kellie Clark's specialty?

The primary specialty registered for this NPI is Licensed Vocational Nurse with taxonomy code 164X00000X.

When was this NPI record last updated?

The NPPES record for Kellie Clark was last updated on May 2, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.