Provider Demographics
NPI:1346437977
Name:MCKINDLEY, JUDETH CHRISTINE (PAC)
Entity Type:Individual
Prefix:MS
First Name:JUDETH
Middle Name:CHRISTINE
Last Name:MCKINDLEY
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10808 FOOTHILL BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-0601
Mailing Address - Country:US
Mailing Address - Phone:909-702-4992
Mailing Address - Fax:909-427-0824
Practice Address - Street 1:10808 FOOTHILL BLVD STE 160
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-0601
Practice Address - Country:US
Practice Address - Phone:909-702-4992
Practice Address - Fax:909-427-0824
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant