Clements, Autum Rae

Clements, Autum Rae is an sole proprietor health care provider with primary practice located at 4295 Brockton Ave , Riverside CA 92501-3446. She recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as her primary health care specialty. Clements, Autum Rae can be contacted via phone (951) 341-3786.

Contact Information

Primary practice address
4295 Brockton Ave Riverside CA 92501-3446
Phone: (951) 341-3786
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X

Profile Details

NPI number 1720747942
LBN Legal business name Clements, Autum Rae
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 15th, 2021
Last updated Feb 8th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720747942 NPPES
California MEDICAID 1487716619

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