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NPI Code Detail

MEDICARE: ALEXIS J MCCLOUD

MEDICARE: ALEXIS J MCCLOUD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1376045435
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS J MCCLOUD
Provider Business Mailing Address
First Line : 2150 RIVER PLAZA DR STE 410
Second Line :
City : SACRAMENTO
State : CA
Zip : 95833-4140
Country : US
Telephone Number : 866-727-8274
Fax Number :
Provider Business Practice Location Address
First Line : 2150 RIVER PLAZA DR STE 410
Second Line :
City : SACRAMENTO
State : CA
Zip : 95833-4140
Country : US
Telephone Number : 866-727-8274
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2018
Last Update Date : 03/05/2018

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Directions to “ ALEXIS J MCCLOUD ” Practice Location

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