Mcclendon, Jaklyn Rae

Mcclendon, Jaklyn Rae is an individual health care provider with primary practice located at 1111 W La Palma Ave Ammc - Dept. Of Pathology, Anaheim CA 92801-2804. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cytopathology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is her primary health care specialty. Mcclendon, Jaklyn Rae can be contacted via phone (714) 999-6075.

Contact Information

Primary practice address
1111 W La Palma Ave Ammc - Dept. Of Pathology Anaheim CA 92801-2804
Phone: (714) 999-6075
Fax: (714) 999-3822
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cytopathology 207ZC0500X G50440 California
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X G50440 California

Profile Details

NPI number 1104889617
LBN Legal business name Mcclendon, Jaklyn Rae
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 7th, 2006
Last updated Oct 4th, 2007 - about 17 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 1104889617 NPPES
California MEDICAID 00G504400

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