Healthcare Provider Details

I. General information

NPI: 1639096993
Provider Name (Legal Business Name): TODD MCBAIN MMC, NMT, CMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3615 BECHELLI LN
REDDING CA
96002-2429
US

IV. Provider business mailing address

4738 AIRPORT RD
REDDING CA
96002-9407
US

V. Phone/Fax

Practice location:
  • Phone: 530-941-1302
  • Fax:
Mailing address:
  • Phone: 530-941-1302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number96335
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: