Healthcare Provider Details

I. General information

NPI: 1760684468
Provider Name (Legal Business Name): MARCELENE MCCLENDON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 06/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 EAST CHAPMAN AVE FLORENCE CRITTENTON SERVICES OF ORANGE COUNTY, INC.
FULLERTON CA
92831-3839
US

IV. Provider business mailing address

801 E CHAPMAN AVE
FULLERTON CA
92831-3839
US

V. Phone/Fax

Practice location:
  • Phone: 714-680-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: