Latisha Marie Clark, APRN in Ventura, CA - Medicare Nurse Practitioner

Latisha Marie Clark, APRN is a medicare enrolled "Nurse Practitioner - Family" in Ventura, California. She graduated from nursing school in 2022 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice The Urgent Care Associates Of Texas Pllc and her current practice location is 5725 Ralston St Ste 101, Ventura, California. You can reach out to her office (for appointments etc.) via phone at (805) 658-2273.

Latisha Marie Clark is licensed to practice in California (license number 95032515) and she also participates in the medicare program. She may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1700590320.

Contact Information

	Latisha Marie Clark, APRN
	5725 Ralston St Ste 101, Ventura, CA 93003-6053
	(805) 658-2273
	Not Available

Map and Direction

Provider's Profile

Full Name	Latisha Marie Clark
Gender	Female
Speciality	Nurse Practitioner
Experience	4 Years
Location	5725 Ralston St Ste 101, Ventura, California
Accepts Medicare Assignments	May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.

Medical Education and Training:

Latisha Marie Clark graduated from nursing school in 2022

NPI Data:

NPI Number: 1700590320
Provider Enumeration Date: 01/09/2023
Last Update Date: 11/03/2025

Medicare PECOS Information:

PECOS PAC ID: 9234502923
Enrollment ID: I20230228001026

Medical Identifiers

Medical identifiers for Latisha Marie Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1700590320	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	95032515 (California)	Primary
363L00000X	Nurse Practitioner	1085990 (Texas)	Secondary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
The Urgent Care Associates Of Texas Pllc	1355665795	17

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Latisha Marie Clark allows following entities to bill medicare on her behalf.

Entity Name	Woodlands Lone Star Emergency Physicians Group Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1679994941 PECOS PAC ID: 5294057444 Enrollment ID: O20141125002147

Entity Name	The Urgent Care Associates Of Texas Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1235539933 PECOS PAC ID: 1355665795 Enrollment ID: O20150113002159

Entity Name	Oak Street Health Of Texas Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1497387419 PECOS PAC ID: 2163843038 Enrollment ID: O20200601001767

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Latisha Marie Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Latisha Marie Clark, APRN 5725 Ralston St Ste 101, Ventura, CA 93003-6053 Ph: (805) 658-2273	Latisha Marie Clark, APRN 5725 Ralston St Ste 101, Ventura, CA 93003-6053 Ph: (805) 658-2273

Reviews and Comments

Nurse Practitioner Nurses in Ventura, CA

Mrs. Molly Hall, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2818 Pierpont Blvd, Ventura, CA 93001 Phone: 805-469-5123
Teresa Hong, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 300 Hillmont Ave Ste 401, Ventura, CA 93003 Phone: 805-652-6201
Lindsay Ann Loft, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 300 Hillmont Ave, Bldg 340, Ste 401, Ventura, CA 93003 Phone: 805-641-0141 Fax: 805-641-0430
Sarah Dinkler, CNM, WHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2945 Loma Vista Rd, Ventura, CA 93003 Phone: 805-667-8003 Fax: 805-667-8404
Colette B Frena, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3555 Loma Vista Rd Ste 110, Ventura, CA 93003 Phone: 805-653-0303 Fax: 805-642-1928
Mrs. Carlie Sue Corse, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2772 Johnson Dr Ste 100, Ventura, CA 93003 Phone: 805-642-1430
Mr. Jason Amurao, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1280 S Victoria Ave Ste 250, Ventura, CA 93003 Phone: 805-351-0745

Latisha Marie Clark, APRN - Medicare Nurse Practitioner in Ventura, CA