Provider Demographics
NPI:1255501128
Name:MCLEAN, REBECCA JEANNE (LAC)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:JEANNE
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3022 W AVENUE L
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-4036
Mailing Address - Country:US
Mailing Address - Phone:661-722-8183
Mailing Address - Fax:
Practice Address - Street 1:3022 W AVENUE L
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-4036
Practice Address - Country:US
Practice Address - Phone:661-722-8183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-07
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 11587171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist