Provider Demographics
NPI:1760289037
Name:MCCLYMONT, KARA MEDULAN
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:MEDULAN
Last Name:MCCLYMONT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:ELLEN
Other - Last Name:MEDULAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3238 BRIGGS AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4803
Mailing Address - Country:US
Mailing Address - Phone:510-914-2206
Mailing Address - Fax:
Practice Address - Street 1:3010 FILLMORE ST
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-5544
Practice Address - Country:US
Practice Address - Phone:510-748-4013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach