Healthcare Provider Details

I. General information

NPI: 1700937596
Provider Name (Legal Business Name): SUSAN RENEE MCCLENDON R.D., C.N.S.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUE MCCLENDON

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 INDUSTRIAL RD
SAN CARLOS CA
94070-2603
US

IV. Provider business mailing address

PO BOX 255228
SACRAMENTO CA
95865-5228
US

V. Phone/Fax

Practice location:
  • Phone: 650-853-2250
  • Fax:
Mailing address:
  • Phone: 800-470-0071
  • Fax: 916-854-6769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number858902
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: