MEDICARE: CLARESHA CLEMONS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program		CA

General Provider Information

NPI Number	:	1821949827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLARESHA CLEMONS

Provider Business Mailing Address
First Line	:	29195 AVENIDA LA PAZ APT 3
Second Line	:
City	:	CATHEDRAL CITY
State	:	CA
Zip	:	92234-3616
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	47915 OASIS ST
Second Line	:
City	:	INDIO
State	:	CA
Zip	:	92201-6950
Country	:	US
Telephone Number	:	760-863-8650
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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Directions to “ CLARESHA CLEMONS ” Practice Location

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