Healthcare Provider Details

I. General information

NPI: 1558256586
Provider Name (Legal Business Name): HANNAH FAITH MCLAIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5241 N MAPLE AVE
FRESNO CA
93740-0001
US

IV. Provider business mailing address

10412 ATAKAPA AVE
BAKERSFIELD CA
93312-5382
US

V. Phone/Fax

Practice location:
  • Phone: 559-278-4240
  • Fax:
Mailing address:
  • Phone: 661-304-9003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number208100000X
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: