Provider Demographics
NPI:1770023996
Name:MCCLENNEY, CAROLYN
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:
Last Name:MCCLENNEY
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 1:4320 AUBURN BLVD
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-4166
Mailing Address - Country:US
Mailing Address - Phone:916-418-0828
Mailing Address - Fax:916-418-0838
Practice Address - Street 1:4320 AUBURN BLVD
Practice Address - Street 2:SUITE 1200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-4166
Practice Address - Country:US
Practice Address - Phone:916-418-0828
Practice Address - Fax:916-418-0838
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator