Provider Demographics
NPI:1225682065
Name:MCCLAIN, GAYLA DENISE (LVN)
Entity Type:Individual
Prefix:
First Name:GAYLA
Middle Name:DENISE
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:GAYLA
Other - Middle Name:DENISE
Other - Last Name:MCCLAIN-CARRILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:200 HILLMONT AVE
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-1647
Mailing Address - Country:US
Mailing Address - Phone:805-652-6729
Mailing Address - Fax:
Practice Address - Street 1:200 HILLMONT AVE
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-1647
Practice Address - Country:US
Practice Address - Phone:805-652-6729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN253311164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse