Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Carrie-Anne Clark, PA-C

Individual provider Surgical Physician Assistant · NPI 1275742462

Carrie-Anne Clark, PA-C is a Physician Assistant in Fullerton, California. Qualified in 2004, 22 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
22
Licensed in
CA
In the registry since
2007
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

100 E Valencia Mesa Dr Ste 105
Fullerton, CA 92835-3813
Phone: (714) 446-5200
Fax: (714) 446-5292
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA17731 (CA)

Record details

NPI number1275742462
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 22, 2007
Last updated in NPPESOctober 20, 2021
Certification dateOctober 20, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Providence Medical Foundation — 1465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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