Individual provider · NPI-1
Ryan Gene Cleveringa
Case Manager/Care Coordinator · Roseville, CA
NPI number1003612714
StatusActive
Last updated in NPPESAug 14, 2025
Details
- NPI
- 1003612714
- Entity type
- Individual (NPI-1)
- Name
- Ryan Gene Cleveringa
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 22, 2025
- Certification date
- Aug 14, 2025
- Last updated
- Aug 14, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
| 225400000X | Rehabilitation Practitioner | – | – |
Practice location
406 Sunrise Ave Ste 300Roseville, CA 95661-4144
Phone 916-783-5207
Mailing address
406 Sunrise Ave Ste 300Roseville, CA 95661-4144
Phone 916-783-5207
Other practice locations
2975 Mcmillan Ave Ste 164
San Luis Obispo, CA 93401-6768
San Luis Obispo, CA 93401-6768
Phone 805-439-4890
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