Provider Demographics
NPI:1780443168
Name:MCKAIN, LILY NOEL ISABELLA
Entity type:Individual
Prefix:
First Name:LILY
Middle Name:NOEL ISABELLA
Last Name:MCKAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:NOEL
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11430 E STILLWATER WAY
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-8778
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11430 E STILLWATER WAY
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-8778
Practice Address - Country:US
Practice Address - Phone:530-339-0580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician