Individual
TINA MARIE MCLEROY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3862 GATTY ST, SAN DIEGO, CA 92154-1645
(619) 253-5850
Mailing address
3862 GATTY ST, SAN DIEGO, CA 92154-1645
(619) 253-5850
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C2585387
DRIVER LICENSE
CA
Enumeration date
10/12/2022
Last updated
10/12/2022
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