Provider Demographics
NPI:1538115795
Name:SCHIEVE, WILLIAM M (LAC,DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:M
Last Name:SCHIEVE
Suffix:
Gender:M
Credentials:LAC,DC
Other - Prefix:DR
Other - First Name:BILL
Other - Middle Name:M
Other - Last Name:SCHIEVE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC,DC
Mailing Address - Street 1:PO BOX 1124
Mailing Address - Street 2:
Mailing Address - City:GUALALA
Mailing Address - State:CA
Mailing Address - Zip Code:95445-1124
Mailing Address - Country:US
Mailing Address - Phone:707-884-4805
Mailing Address - Fax:
Practice Address - Street 1:39120 CYPRESS WAY
Practice Address - Street 2:
Practice Address - City:GUALALA
Practice Address - State:CA
Practice Address - Zip Code:95445-8310
Practice Address - Country:US
Practice Address - Phone:707-884-4805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20122111N00000X
CA3220171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA0032200OtherBLUE SHIELD
CADC0201220Medicare ID - Type Unspecified
CACA0032200OtherBLUE SHIELD