Provider Demographics
NPI:1194956136
Name:BRENAN-KEY, CLARA I (PHD)
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:I
Last Name:BRENAN-KEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 S EUCLID ST STE 111
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-2857
Mailing Address - Country:US
Mailing Address - Phone:714-446-9144
Mailing Address - Fax:562-299-5912
Practice Address - Street 1:905 S EUCLID ST STE 111
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-2857
Practice Address - Country:US
Practice Address - Phone:714-446-9144
Practice Address - Fax:562-299-5912
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12142171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC12142OtherACUPUNCTURE