Provider Demographics
NPI:1063784478
Name:ENCE, EMILY CLARK (PA-C)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:CLARK
Last Name:ENCE
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:9850 GENESEE AVE 320
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1208
Mailing Address - Country:US
Mailing Address - Phone:858-554-1212
Mailing Address - Fax:858-554-1222
Practice Address - Street 1:9850 GENESEE AVE STE 320
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1208
Practice Address - Country:US
Practice Address - Phone:858-554-1212
Practice Address - Fax:858-554-1222
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2018-12-04
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Provider Licenses
StateLicense IDTaxonomies
CAPA52084363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant