CHERYL CLEMENTSON (NPI# 1851760565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851760565 |
| Entity Type | Individual |
| Full Name | CHERYL CLEMENTSON |
| Practice Address |
301 Smith Ranch Road San Rafael CA 94903 |
| Mailing Address |
Po Box 5338 Novato CA 94948-5338 |
| Practice Telephone | 4154920818 |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2015-09-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | A3839173 | 05 |
| Street Address |
301 SMITH RANCH ROAD |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467089524 | Christopher Sazo | Counselor | 1 St. Vincents Drive, San Rafael, CA 94903 | 2020-03-26 |
| 1134769482 | Katherine Sieger | Music Therapist | 400 Civic Center Dr. #300, San Rafael, CA 94903 | 2020-01-14 |
| 1679064836 | California In Home Care & Registry, Inc | In Home Supportive Care | 14b Mitchell Blvd, Suite B, San Rafael, CA 94903 | 2018-05-23 |
| 1922557586 | Helen Elizabeth Shamis | Marriage & Family Therapist | 30 North San Pedro, Suite #265, Beyond Hunger, San Rafael, CA 94903 | 2016-09-23 |
| 1033572771 | Henry Colbert | Counselor | 1 St. St. Vincent Drive, San Rafael, CA 94903 | 2016-03-31 |
| 1659736924 | Robyn Bloom | Marriage & Family Therapist | 4 Joseph Court, San Rafael, CA 94903 | 2015-12-30 |
| 1588043731 | Chelsea Cooney | Counselor | 1 St. Vincent's Drive, San Rafael, CA 94903 | 2015-05-20 |
| 1083002315 | Kaiser Permanente | Psychiatric Unit | 111 Smith Ranch Road, Kaiser Permanente, San Rafael, CA 94903 | 2015-01-09 |
| 1366857856 | Travel Well Corporation | Preventive Medicine | 28 Mitchell Blvd, San Rafael, CA 94903 | 2014-06-24 |
| 1851718498 | Mayra Guzman | Pharmacist | 950 Las Gallinas Av, San Rafael, CA 94903 | 2014-03-20 |
| Find all providers in zip 94903 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982246815 | Ca Ya Services LLC | Substance Abuse Rehabilitation Facility | 285 Margarita Dr, San Rafael, CA 94901-2329 | 2019-10-11 |
| 1295104420 | Robert Bostonian | Substance Abuse Rehabilitation Facility | 67 Grande Paseo, San Rafael, CA 94903-1555 | 2015-09-17 |
| 1982071833 | Brian Finley | Substance Abuse Rehabilitation Facility | 195 Nova Albion Way Apt 21, San Rafael, CA 94903-4528 | 2015-08-26 |
| 1003206228 | Helen Vine Recovery Center | Substance Abuse Rehabilitation Facility | 291 Smith Ranch Rd, San Rafael, CA 94903-5551 | 2015-01-26 |
| 1669716361 | North Bay Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 55 Shaver St, San Rafael, CA 94901-2787 | 2012-11-19 |
| 1801041074 | Bayside Marin, LLC | Substance Abuse Rehabilitation Facility | 718 4th St, San Rafael, CA 94901-3213 | 2008-12-01 |
| 1316169576 | Center Point, Inc. | Substance Abuse Rehabilitation Facility | 39 Mary St, San Rafael, CA 94901-3451 | 2007-05-03 |
| 1235351487 | Center Point, Inc. | Substance Abuse Rehabilitation Facility | 519 Belle Ave, San Rafael, CA 94901-3414 | 2007-05-03 |
| 1760601355 | Center Point, Inc. | Substance Abuse Rehabilitation Facility | 812 D St, San Rafael, CA 94901-2814 | 2007-04-24 |
| 1851510440 | Center Point, Inc | Substance Abuse Rehabilitation Facility | 1477 Lincoln Ave, San Rafael, CA 94901-2028 | 2007-04-24 |
| Find all providers in SAN RAFAEL | ||||
| City | SAN RAFAEL |
| Zip Code | 94903 |
Please comment or provide details below to improve the information on CHERYL CLEMENTSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.