Healthcare Provider Details

I. General information

NPI: 1952238339
Provider Name (Legal Business Name): CLARIVOLVE MENTAL HEALTH NURSING PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 E OLIVE AVE STE 100
REDLANDS CA
92373-5255
US

IV. Provider business mailing address

104 E OLIVE AVE STE 100
REDLANDS CA
92373-5255
US

V. Phone/Fax

Practice location:
  • Phone: 952-517-3701
  • Fax: 951-269-4032
Mailing address:
  • Phone: 952-517-3701
  • Fax: 951-269-4032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ALIREZA NIKPOUR
Title or Position: PRESIDENT
Credential: PMHNP-BC
Phone: 626-222-9599