Provider Demographics
NPI:1982835781
Name:MCLAIN, STACY LYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:LYNN
Last Name:MCLAIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4195 CHINO HILLS PKWY
Mailing Address - Street 2:#350
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-2618
Mailing Address - Country:US
Mailing Address - Phone:909-641-4731
Mailing Address - Fax:951-340-2872
Practice Address - Street 1:4195 CHINO HILLS PKWY
Practice Address - Street 2:#350
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-2618
Practice Address - Country:US
Practice Address - Phone:909-641-4731
Practice Address - Fax:951-340-2872
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17699103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist