Provider Demographics
NPI:1922798784
Name:MCLACHLAN, ANA HORGA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:HORGA
Last Name:MCLACHLAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 S PROSPECT AVE UNIT 205
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-4419
Mailing Address - Country:US
Mailing Address - Phone:310-927-7380
Mailing Address - Fax:
Practice Address - Street 1:615 S PROSPECT AVE UNIT 205
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-4419
Practice Address - Country:US
Practice Address - Phone:310-927-7380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84251225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist