Provider Demographics
NPI:1275601684
Name:MCLEOD, RENEE PARNELL (DNSC, APRN, CPNP)
Entity Type:Individual
Prefix:DR
First Name:RENEE
Middle Name:PARNELL
Last Name:MCLEOD
Suffix:
Gender:F
Credentials:DNSC, APRN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14452 CORTE MOREA
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-3812
Mailing Address - Country:US
Mailing Address - Phone:858-484-8210
Mailing Address - Fax:858-484-3966
Practice Address - Street 1:4020 5TH AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2106
Practice Address - Country:US
Practice Address - Phone:619-260-7278
Practice Address - Fax:619-260-7310
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA272669363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1391Medicare ID - Type UnspecifiedNPI NUMBER