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General NPI Number Information
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NPI Number | 1760200547
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Entity Type | Individual
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Provider Name | MCKENNA ZARRELL PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 1375 BLOSSOM HILL RD STE 49
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City | SAN JOSE
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State | CA
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Zip | 95118-3806
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Country | US
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Telephone | 408-645-7073
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Fax |
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Provider Business Mailing Address
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Address Line | 1038 E BROKAW RD # 30
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City | SAN JOSE
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State | CA
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Zip | 95131-2309
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Country | US
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Telephone | 408-703-4400
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA65154
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License Number State | CA
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