Jan Clements, APRN
Individual provider Active NPI Gerontology Nurse Practitioner · San Mateo, CA
NPI 1124449285 · NPPES record last updated Oct 14, 2025
Key facts
- NPI
- 1124449285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- 193894-4405 (UT)
- Practice address
- 1875 S Grant St
San Mateo, CA 94402-2666 - Phone
- (888) 227-8884
- NPI assigned
- Dec 16, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 10
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Resolutioncare PC
Practice addresses (Care Compare)
1875 S Grant St
Suite 760
San Mateo, CA 94402-2670
Phone (707) 442-5683
Hospital & facility affiliations
- Copper Ridge Health Care
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in UT, CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140319001143 | UT | Practitioner - Nurse Practitioner | 7113158981 | Reassigns benefits to 3 organizations |
| I20190123002823 | UT | Practitioner - Nurse Practitioner | 7113158981 |
Reassigns benefits to 1 organization Practice locations: Cottonwood Heights, UT |
| I20250919004328 | CA | Practitioner - Nurse Practitioner | 7113158981 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 193894-4405 | UT | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ma Bo Inc | Current |
Accepting new patients | |
| Ihc Health Services Inc | Current |
Accepting new patients | |
| Utah Regional Hospitalists LLC | Current |
Accepting new patients | |
| Utah Regional Hospitalists LLC | Current |
Accepting new patients | |
| Ihc Health Services, Inc. | Current |
Accepting new patients | |
| Hawaiian Palliative Care LLC | Current |
Accepting new patients | |
| Resolutioncare, PC | Current |
Accepting new patients | |
| Vynca Medical Associates PA | Current |
Accepting new patients | |
| Ma Bo Inc | Current | Accepting new patients |
Locations
1875 S Grant St
Ste 760
San Mateo, CA 94402
Phone (707) 442-5683
1875 S Grant St
San Mateo, CA 94402
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
466 E 500 S
Ste 200
Salt Lake Cty, UT 84111
Phone (801) 485-5055
1200 E 3900 S
Slc, UT 84124
Phone (801) 268-7111
11520 S Redwood Rd
South Jordan, UT 84095
Phone (385) 887-6000
11444 S Redwood Rd
South Jordan, UT 84095
Phone (801) 253-5900
451 E Bishop Federal Ln
South Salt Lake, UT 84115
Phone (801) 487-7557
5255 S 4015 W
Ste 207D
Taylorsville, UT 84129
3460 S Pioneer Pkwy
West Valley City, UT 84120
Phone (801) 964-3111
Interoperability endpoints
- https://api.platform.athenahealth.com/10606/brand/1/csg/1/fhir/r4
- jan.clements.1@10606.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 193894-4405 | UT | |
| Gerontology Nurse Practitioner | 363LG0600X | 95035474 | CA | |
| Gerontology Nurse Practitioner | 363LG0600X | 193894-4405 | UT | Yes |
Addresses
Primary practice location
1875 S Grant St
San Mateo, CA 94402-2666
Mailing address
1875 S Grant St
San Mateo, CA 94402-2666
Phone (888) 227-8884
Other practice location 1
1605 E Shadow Cv
Cottonwood Heights, UT 84121-3664
Phone (435) 770-6594
Other practice location 2
789 Bamberger Dr
Suite B
American Fork, UT 84003-2181
Phone (801) 599-7848
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124449285 | Medicaid | UT |
Other providers in San Mateo, CA
- Trecher Lee Clay
- Clear Optometry
- Renee M Cleek
- David Ross Clemens
- Marie Clemente
- Daniel Vincent Clevenger
- Ronald Harrison Clifton Jr.
- Clinical Integrative Services, Inc
- Clinical Psychology Solutions PLLC
- Penelope Clizbe
All providers in San Mateo, CA · Gerontology Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.