Autum Rae Clements

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

4295 Brockton Ave
Riverside, CA 92501-3446

Phone

(951) 341-3786

NPI assigned

Dec 15, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mfi Recovery Center

  • Substance Abuse Rehabilitation Facility
  • Riverside, CA
  • NPI 1689049314
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1720747942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5870 ARLINGTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925042037",
            "telephone_number": "951-683-6596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4295 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013446",
            "telephone_number": "951-341-3786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10001 County Farm Rd",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925033507",
            "country_code": "US",
            "telephone_number": "951-358-4382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEMENTS",
        "first_name": "AUTUM",
        "middle_name": "RAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-15",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487716619",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cleansing Conversations
• Clear Path Hill Top LLC
• Clear Vision Out Patient Recovery Center
• Clear Vision, LLC. (Clear Vision Recovery Center)
• Madison Clem
• Bill Clemon Joseph Clemon X
• Brittany Clemons
• Sheryl Lynn Clemons, OTRL
• Hayley Noelle Cliatt, PHARMD
• Clifford C Douglas MD Inc

• Peer Specialist in Riverside, CA
• Providers in Riverside, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.