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NPI Code Detail

MEDICARE: MISS JENNEFER ANN MCLEAN

MEDICARE: MISS JENNEFER ANN MCLEAN
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1659459105
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JENNEFER ANN MCLEAN
Provider Business Mailing Address
First Line : 4329 BEVERLY DR
Second Line :
City : SANTA MARIA
State : CA
Zip : 93455-6706
Country : US
Telephone Number : 805-938-1350
Fax Number :
Provider Business Practice Location Address
First Line : 117 N B ST
Second Line :
City : LOMPOC
State : CA
Zip : 93436-6901
Country : US
Telephone Number : 805-737-6690
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/08/2007

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Directions to “ MISS JENNEFER ANN MCLEAN ” Practice Location

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