Healthcare Provider Details

I. General information

NPI: 1568329076
Provider Name (Legal Business Name): MR. EITAN SPANIER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2232 CARLETON ST
BERKELEY CA
94704-3225
US

IV. Provider business mailing address

924 FRESNO AVE
BERKELEY CA
94707-2305
US

V. Phone/Fax

Practice location:
  • Phone: 510-858-4844
  • Fax:
Mailing address:
  • Phone: 510-684-8792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: