Provider Demographics
NPI:1710297114
Name:MCLEAN, TREESA ANN (LM, CPM)
Entity Type:Individual
Prefix:MS
First Name:TREESA
Middle Name:ANN
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 STAFFORD AVE
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-3028
Mailing Address - Country:US
Mailing Address - Phone:510-581-1013
Mailing Address - Fax:
Practice Address - Street 1:1540 STAFFORD AVE
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-3028
Practice Address - Country:US
Practice Address - Phone:510-581-1013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-19
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife