Healthcare Provider Details

I. General information

NPI: 1730099631
Provider Name (Legal Business Name): MARLENE H MCBRIDE DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 KINGS CT
UKIAH CA
95482-5003
US

IV. Provider business mailing address

305 OAK MANOR DR
UKIAH CA
95482-5117
US

V. Phone/Fax

Practice location:
  • Phone: 707-468-7700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number588227
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: