Provider Demographics
NPI:1821676461
Name:MCCLIVE, ERIN (DC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MCCLIVE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SAGE
Other - Middle Name:
Other - Last Name:MCCLIVE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1320 HARBOR BAY PKWY STE 104
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94502-2203
Mailing Address - Country:US
Mailing Address - Phone:510-864-9339
Mailing Address - Fax:
Practice Address - Street 1:1320 HARBOR BAY PKWY STE 104
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94502-2203
Practice Address - Country:US
Practice Address - Phone:510-864-9339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34919111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor