Provider Demographics
NPI:1538188537
Name:MCLEAN, ANNE M
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:M
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ANNE
Other - Middle Name:DOYLE
Other - Last Name:MCLEAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:6908 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-5607
Mailing Address - Country:US
Mailing Address - Phone:858-459-1926
Mailing Address - Fax:858-454-1622
Practice Address - Street 1:4550 KEARNY VILLA RD
Practice Address - Street 2:SUITE 116
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1578
Practice Address - Country:US
Practice Address - Phone:858-751-5945
Practice Address - Fax:858-279-6154
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37994171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor