Provider Demographics
NPI:1356524003
Name:WHITMORE, EVA LYNNE (DC)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:LYNNE
Last Name:WHITMORE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4168 PIEDMONT AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5172
Mailing Address - Country:US
Mailing Address - Phone:510-450-0701
Mailing Address - Fax:510-547-1039
Practice Address - Street 1:4168 PIEDMONT AVE
Practice Address - Street 2:SUITE E
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5172
Practice Address - Country:US
Practice Address - Phone:510-450-0701
Practice Address - Fax:510-547-1039
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28197111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor