Basic Information
Provider Information
NPI: 1245706456
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCCAIN
FirstName: DANALI
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: ASW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1227 W CAMBRIDGE AVE
Address2:  
City: VISALIA
State: CA
PostalCode: 932774622
CountryCode: US
TelephoneNumber: 5597415277
FaxNumber:  
Practice Location
Address1: 520 E TULARE AVE
Address2:  
City: VISALIA
State: CA
PostalCode: 932923629
CountryCode: US
TelephoneNumber: 5596230900
FaxNumber: 5597133756
Other Information
ProviderEnumerationDate: 10/16/2018
LastUpdateDate: 02/16/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/16/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N193200000X MULTI-SPECIALTY GROUPStudent, Health CareStudent in an Organized Health Care Education/Training Program 
1041C0700XASW97203CAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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