Cheryl Clementson

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

122225 Issued in CA

Practice address

710 C St Ste 7C
San Rafael, CA 94901-3891

Phone

(415) 639-5373

NPI assigned

Sep 23, 2015

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1851760565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5338",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949485338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 C ST STE 7C",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013891",
            "telephone_number": "415-639-5373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 Hyde St Ste 300",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941095998",
            "country_code": "US",
            "telephone_number": "415-639-5373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEMENTSON",
        "first_name": "CHERYL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-23",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "122225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A3839173",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claudine Katherine Clarke, M. S.
• Nicole Marie Clausen, PHARM.D.
• Kaelen Clayton
• Tammy Swahn Cleland
• Stacey Nelson Clemenceau, PH.D.
• Tiffany Ann Cleveland
• Jean Clinton, LPC
• Kelly Clohessy, LAC
• Gina Noelle Cloney, NP
• John L Clothier, M.D.

• Marriage & Family Therapist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.