Provider Demographics
NPI:1174944227
Name:SPERLING, BEVERLY (LPT)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:SPERLING
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6541 6TH ST
Mailing Address - Street 2:
Mailing Address - City:RIO LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:95673-3910
Mailing Address - Country:US
Mailing Address - Phone:916-873-4106
Mailing Address - Fax:
Practice Address - Street 1:6541 6TH ST
Practice Address - Street 2:
Practice Address - City:RIO LINDA
Practice Address - State:CA
Practice Address - Zip Code:95673-3910
Practice Address - Country:US
Practice Address - Phone:916-873-4106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT24750167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician