Provider Demographics
NPI:1376832022
Name:MCLAIN, BARBARA RUTH (NP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:RUTH
Last Name:MCLAIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1949 NICASIO VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:NICASIO
Mailing Address - State:CA
Mailing Address - Zip Code:94946-9752
Mailing Address - Country:US
Mailing Address - Phone:415-662-6275
Mailing Address - Fax:
Practice Address - Street 1:17 E SIR FRANCIS DRAKE BLVD
Practice Address - Street 2:
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-1727
Practice Address - Country:US
Practice Address - Phone:415-526-5538
Practice Address - Fax:415-925-9557
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA298596363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health