Provider Demographics
NPI:1063215242
Name:MCCANN, MEGHAN ADELE
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ADELE
Last Name:MCCANN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10755 SCRIPPS POWAY PKWY
Mailing Address - Street 2:SUITE F #103
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-3924
Mailing Address - Country:US
Mailing Address - Phone:858-699-5040
Mailing Address - Fax:
Practice Address - Street 1:10755 SCRIPPS POWAY PKWY
Practice Address - Street 2:SUITE F #103
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-3924
Practice Address - Country:US
Practice Address - Phone:858-699-5040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95076521363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health