LATISHA MARIE CLARK

VENTURA, CA
NPI1700590320
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: CA  95032515)
Additional Taxonomies363L00000X Nurse Practitioner
(Licence: TX  1085990)
Enumeration Date2023-01-09
Last Update Date2025-11-03
Business Address
LATISHA MARIE CLARK APRN
5725 RALSTON ST STE 101
VENTURA, CA 93003-6053
Phone number: 805-658-2273
Mailing Address
LATISHA MARIE CLARK APRN
5725 RALSTON ST STE 101
VENTURA, CA 93003-6053
Phone number: 805-658-2273