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

Christina Marie Clack, PNPC

Individual provider Pediatric Nurse Practitioner · NPI 1699365601

Christina Marie Clack, PNPC is a Pediatric Nurse Practitioner in Los Angeles, California. Works from 2 locations. Licensed in California.

Licensed in
CA
In the registry since
2021
Specialties on file
2

Practice location Address checks out

808 W 58th St
Los Angeles, CA 90037-3632
Phone: (323) 541-1600
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2601 E Main St Ste 200, Ventura, CA 93003-2801 — (805) 643-7500

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence 95015295 (CA)
Nurse Practitioner Taxonomy 363L00000X · Licence 95015295 (CA)

Record details

NPI number1699365601
Entity typeIndividual (Type 1)
GenderFemale
Credentials PNPC
Sole proprietorNo
NPI enumeratedJanuary 23, 2021
Last updated in NPPESJuly 17, 2025
Certification dateJuly 17, 2025

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