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General NPI Number Information
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NPI Number | 1720728199
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Entity Type | Individual
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Provider Name | ANDREW WILLIAM CLEAVER
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Gender | Male
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Dates
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Enumeration Date | 03/31/2022
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Last Update Date | 07/06/2023
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Provider Practice Location Address
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Address Line | 10535 HOSPITAL WAY
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City | MATHER
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State | CA
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Zip | 95655-4200
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Country | US
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Telephone | 916-843-2752
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Fax |
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Provider Business Mailing Address
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Address Line | 8517 OAK AVE UNIT B
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City | ORANGEVALE
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State | CA
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Zip | 95662-2332
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Country | US
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Telephone | 206-557-2769
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 60279027
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License Number State | WA
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