Search › California › 1041C0700X

Champagne Clark

NPI 1306323563 · on the registry since 2018

Practice

Address
500b Jefferson Blvd
West Sacramento, CA 95605
Phone
(916) 403-2990
Organisation at this address
Ole Health
Imgrx Salud Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
16

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Also registered as
390200000X
Licence states on file
CA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2021-12-30

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California