Clennon, Maria

Clennon, Maria is an sole proprietor health care provider with primary practice located at 226 E Maple Ave , Monrovia CA 91016-3549. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Clennon, Maria can be contacted via phone (626) 930-1938.

Contact Information

Primary practice address
226 E Maple Ave Monrovia CA 91016-3549
Phone: (626) 930-1938
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 22180 California

Profile Details

NPI number 1649692534
LBN Legal business name Clennon, Maria
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 10th, 2014
Last updated Jan 22nd, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649692534 NPPES
California MEDICAID 22180

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