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

Kellie Clark

Individual provider Licensed Vocational Nurse · NPI 1356962138

Kellie Clark is a Licensed Vocational Nurse in San Diego, California. Licensed in California. Registered with an NPI since 2020.

Licensed in
CA
In the registry since
2020

Practice location Address checks out

734 10th Ave
San Diego, CA 92101-6502
Phone: (619) 239-4663
Show map & directions

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

Specialties & licences

Licensed Vocational Nurse (primary) Taxonomy 164X00000X · Licence 209282 (CA)

Record details

NPI number1356962138
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 2, 2020
Last updated in NPPESMay 2, 2020
Certification dateMay 2, 2020

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