Provider Demographics
NPI:1528261393
Name:MCCLUNG, BARBARA A
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:MCCLUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 SANTA CLARA AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4416
Mailing Address - Country:US
Mailing Address - Phone:510-332-2552
Mailing Address - Fax:510-865-1930
Practice Address - Street 1:2233 SANTA CLARA AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4416
Practice Address - Country:US
Practice Address - Phone:510-332-2552
Practice Address - Fax:510-865-1930
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 38094106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist