Provider Demographics
NPI:1437351749
Name:CLEMENTS, DWYANE JOSEPH I
Entity type:Individual
Prefix:MR
First Name:DWYANE
Middle Name:JOSEPH
Last Name:CLEMENTS
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12440 IMPERIAL HWY STE 770
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-3177
Mailing Address - Country:US
Mailing Address - Phone:213-220-1915
Mailing Address - Fax:
Practice Address - Street 1:12440 IMPERIAL HWY STE 770
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-3177
Practice Address - Country:US
Practice Address - Phone:562-402-0688
Practice Address - Fax:562-402-3032
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist