AUTUM RAE CLEMENTS NPI 1720747942

NPI Information

NPI: 1720747942
Provider Name: AUTUM RAE CLEMENTS
Classification: Peer Specialist - 175T00000X
Entity Type: Individual
Address:
4295 BROCKTON AVE
RIVERSIDE, CA
ZIP 92501
Phone: (951) 341-3786
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Autum Rae Clements is a peer specialist in Riverside, CA. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. Autum Rae Clements NPI is 1720747942. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4295 BROCKTON AVE
RIVERSIDE, CA
ZIP 92501-446
Phone: (951) 341-3786

The enumeration date for this NPI number is 12/15/2021 and was last updated on 2/8/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	175T00000X	Peer Specialist				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1487716619	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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