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Individual

ASHLEY DANIELS MCCLELLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
12450 VAN NUYS BLVD STE 200, PACOIMA, CA 91331-1393
(818) 896-1161
(818) 896-1161
Mailing address
12450 VAN NUYS BLVD STE 200, PACOIMA, CA 91331-1393
(818) 896-1161
(818) 896-1161

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6758
CA
05
7068
CA
05
7420
CA
Enumeration date
11/27/2018
Last updated
11/27/2018
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