Active NPI
Roshanda Clemons, MD
- Pediatrics Physician
- San Bernardino, CA
National Provider Identifier
1922237916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A73304
- Practice address
- 190 E Highland Ave
San Bernardino, CA 92404-3658 - Phone
- (909) 882-4788
- Fax
- (877) 860-7268
- NPI assigned
- Jul 10, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A73304 | CA | Primary |
Addresses
Primary practice location
190 E Highland Ave
San Bernardino, CA 92404-3658
Mailing address
200 Oceangate
Suite 100
Long Beach, CA 90802-4317
Phone (562) 499-6191
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467849600000",
"number": "1922237916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 OCEANGATE",
"address_2": "SUITE 100",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908024317",
"telephone_number": "562-499-6191",
"fax_number": "562-499-6171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 E HIGHLAND AVE",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924043658",
"telephone_number": "909-882-4788",
"fax_number": "877-860-7268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEMONS",
"first_name": "ROSHANDA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-10",
"last_updated": "2016-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A73304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.