Provider Demographics
NPI:1942692793
Name:CLEARWATER, CHERYL (LM)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:CLEARWATER
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 PARK RD
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-2933
Mailing Address - Country:US
Mailing Address - Phone:805-861-6900
Mailing Address - Fax:
Practice Address - Street 1:305 PARK RD
Practice Address - Street 2:
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-2933
Practice Address - Country:US
Practice Address - Phone:805-861-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM417176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife