Provider Demographics
NPI:1972654481
Name:MCGRAIN, JUDY LYNNE (DC)
Entity Type:Individual
Prefix:DR
First Name:JUDY
Middle Name:LYNNE
Last Name:MCGRAIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14127 CAPRI DR
Mailing Address - Street 2:STE. 7
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1534
Mailing Address - Country:US
Mailing Address - Phone:408-370-6886
Mailing Address - Fax:408-370-7230
Practice Address - Street 1:14127 CAPRI DR
Practice Address - Street 2:STE. 7
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1534
Practice Address - Country:US
Practice Address - Phone:408-370-6886
Practice Address - Fax:408-370-7230
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-13
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA016735111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU30774Medicare UPIN
CADC0167350Medicare PIN