Provider Demographics
NPI:1053858456
Name:MCLENDON, ASHLEY (ATS)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:MCLENDON
Suffix:
Gender:F
Credentials:ATS
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:MCLENDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8432 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-3206
Mailing Address - Country:US
Mailing Address - Phone:951-689-5771
Mailing Address - Fax:
Practice Address - Street 1:13190 DAY ST
Practice Address - Street 2:#212
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-7340
Practice Address - Country:US
Practice Address - Phone:615-496-4443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program