Provider Demographics
NPI:1720374549
Name:MCCLAIN, KATE A (RD)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:A
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 N DOUTY ST
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-3722
Mailing Address - Country:US
Mailing Address - Phone:559-537-2039
Mailing Address - Fax:
Practice Address - Street 1:555 E TACHEVAH DR
Practice Address - Street 2:2E-101
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-5750
Practice Address - Country:US
Practice Address - Phone:760-778-5220
Practice Address - Fax:760-778-5221
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA994565133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty