Provider Demographics
NPI:1417159849
Name:CLELAND, DON W (DNP, CNP)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:W
Last Name:CLELAND
Suffix:
Gender:M
Credentials:DNP, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2830 HIGHLAND BLUFFS DR
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-5129
Mailing Address - Country:US
Mailing Address - Phone:530-518-8923
Mailing Address - Fax:
Practice Address - Street 1:118 BELLE MILL RD
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-2850
Practice Address - Country:US
Practice Address - Phone:530-840-2002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA664579163W00000X
CA69253163WC1500X
174H00000X
CA218162278G1100X
CA22100363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No174H00000XOther Service ProvidersHealth Educator
No2278G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGeneral Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily