Provider Demographics
NPI:1932318045
Name:MCCLINTOCK, FRANCENE GAIL (LPT)
Entity Type:Individual
Prefix:MS
First Name:FRANCENE
Middle Name:GAIL
Last Name:MCCLINTOCK
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:487 E. MAIN ST.
Mailing Address - Street 2:#312
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-2626
Mailing Address - Country:US
Mailing Address - Phone:805-507-6446
Mailing Address - Fax:309-685-3769
Practice Address - Street 1:75 E. THOUSAND OAKS BLVD.
Practice Address - Street 2:STE E
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5767
Practice Address - Country:US
Practice Address - Phone:805-288-1199
Practice Address - Fax:805-259-4555
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.009121225100000X
CAPT294128225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL07232025OtherBCBS OF IL
IL07232025OtherBCBS OF IL