Healthcare Provider Details

I. General information

NPI: 1184547341
Provider Name (Legal Business Name): CLEARWATER CARE PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 VALLEY VISTA DR STE 200
DIAMOND BAR CA
91765-3921
US

IV. Provider business mailing address

1370 VALLEY VISTA DR STE 200
DIAMOND BAR CA
91765-3921
US

V. Phone/Fax

Practice location:
  • Phone: 310-345-7633
  • Fax:
Mailing address:
  • Phone: 310-345-7633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MARLANA CLARK
Title or Position: CEO
Credential:
Phone: 310-345-7633