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NPI Code Detail

MEDICARE: SPENCER NOLAN

MEDICARE: SPENCER NOLAN
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
1106S00000XBehavior TechnicianUT

General Provider Information

NPI Number : 1326970799
Entity Type Code : Individual
Provider Name (Legal Business Name) : SPENCER NOLAN
Provider Business Mailing Address
First Line : 16255 VENTURA BLVD
Second Line :
City : ENCINO
State : CA
Zip : 91436-2302
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 585 E 1860 S BLDG 6
Second Line :
City : PROVO
State : UT
Zip : 84606-7312
Country : US
Telephone Number : 801-935-4171
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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585 E 1860 S BLDG 6
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84606-7312
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1518899616 — TERESA HANSEN
Practice Location Address:
585 E 1860 S BLDG 6
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84606-7312
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Practice Fax:
1518899665 — SAVANNAH GAY
Practice Location Address:
585 E 1860 S BLDG 6
PROVO, UT
84606-7312
Practice Phone: 801-935-4171
Practice Fax:

Directions to “ SPENCER NOLAN ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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