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NPI Code Detail

MEDICARE: MS. TINA MARIE MCCLAIN CADC-1

MEDICARE: MS. TINA MARIE MCCLAIN CADC-1
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCI22200120CA

General Provider Information

NPI Number : 1275106387
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TINA MARIE MCCLAIN CADC-1
Provider Business Mailing Address
First Line : 33859 10TH ST APT 3
Second Line :
City : UNION CITY
State : CA
Zip : 94587-3596
Country : US
Telephone Number : 510-329-7391
Fax Number :
Provider Business Practice Location Address
First Line : 1342 E 27TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94606-3266
Country : US
Telephone Number : 510-535-0611
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2021
Last Update Date : 02/02/2026

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