Provider Demographics
NPI:1730772690
Name:SPEARS, NANCY (MFT)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:SPEARS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 MOBIL AVE STE 205G
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-6373
Mailing Address - Country:US
Mailing Address - Phone:805-419-6551
Mailing Address - Fax:
Practice Address - Street 1:360 MOBIL AVE STE 205G
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6373
Practice Address - Country:US
Practice Address - Phone:805-419-6551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85851101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health