Individual provider · Type 1 NPI
Cynthia Rae Clark, F.N.P.
Pediatric Nurse Practitioner · Vista, CA
NPI number
1679698849
Active
Practice location
1000 Vale Terrace Dr
Vista, CA 92084-5218
Mailing address
3860 Calle Fortunada, Suite 210
San Diego, CA 92123-4800
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | NP16833 (CA) |
| Family Nurse Practitioner | 363LF0000X | NP16833 (CA) |
| Pediatric Registered Nurse | 163WP0200X | RN575767 (CA) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1679698849
Cynthia Rae Clark, F.N.P.'s National Provider Identifier is 1679698849, issued on Mar 20, 2007. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Vista, CA. The record was last updated on May 29, 2026.