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General NPI Number Information
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NPI Number | 1275480766
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Entity Type | Individual
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Provider Name | RYANNE MCCLELLAN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/13/2026
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 6180 BROCKTON AVE STE 204
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City | RIVERSIDE
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State | CA
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Zip | 92506-2233
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Country | US
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Telephone | 951-781-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 742 TORREY CT
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City | PERRIS
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State | CA
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Zip | 92571-5165
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Country | US
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Telephone | 313-895-6464
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 95038950
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License Number State | CA
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