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General NPI Number Information
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NPI Number | 1245773696
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Entity Type | Individual
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Provider Name | CRYSTAL J MCCLELLAND LMFT
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Gender | Female
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Dates
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Enumeration Date | 12/02/2016
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Last Update Date | 03/02/2021
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Provider Practice Location Address
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Address Line | 2601 E CHAPMAN AVE SUITE 102
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City | FULLERTON
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State | CA
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Zip | 92831-3737
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Country | US
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Telephone | 949-702-1681
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Fax |
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Provider Business Mailing Address
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Address Line | 20351 SW ACACIA ST FL 2
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-1527
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Country | US
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Telephone | 877-844-8783
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 124435
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 174V00000X
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Taxonomy Name | Clinical Ethicist
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License Number |
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License Number State |
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