Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174V00000X | Clinical Ethicist |
NPI | 1245773696 |
---|---|
Provider Name | Crystal J Mcclelland |
First Address | Newport Beach, CA 92660-1527 |
Second Address | Fullerton, CA 92831-3737 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2016 |
Last Update Date | 02/03/2021 |