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

Kaitlyn A Clark

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1073393625

Kaitlyn A Clark is a Student in an Organized Health Care Education/Training Program in San Mateo, California. Practices as a sole proprietor. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

3701 Hacienda St
San Mateo, CA 94403-4366
Phone: (650) 539-0340
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1073393625
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 2, 2023
Last updated in NPPESOctober 2, 2023
Certification dateOctober 2, 2023
Mailing address3701 Hacienda St, San Mateo, CA 94403-4366

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