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

Latisha Marie Clark, APRN

Individual provider Nurse Practitioner · NPI 1700590320

Latisha Marie Clark, APRN is a Nurse Practitioner in Ventura, California. Qualified in 2022, 4 years ago. Practices with Cottage Clinical Network LLC, a 56-clinician group. Licensed in California and Texas.

Years since qualifying
4
Licensed in
CA, TX
In the registry since
2023
Specialties on file
2
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

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Practice location Address checks out

5725 Ralston St Ste 101
Ventura, CA 93003-6053
Phone: (805) 658-2273
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 95032515 (CA)
Nurse Practitioner Taxonomy 363L00000X · Licence 1085990 (TX)

Record details

NPI number1700590320
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN
Sole proprietorYes
NPI enumeratedJanuary 9, 2023
Last updated in NPPESJune 24, 2026
Certification dateJune 24, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Cottage Clinical Network Llc — 56 clinicians
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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