Healthcare Provider Details

I. General information

NPI: 1538561402
Provider Name (Legal Business Name): MICHELLE YENNHI SPATZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2014
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 EL CAMINO REAL
CARLSBAD CA
92008-1273
US

IV. Provider business mailing address

2510 EL CAMINO REAL
CARLSBAD CA
92008-1273
US

V. Phone/Fax

Practice location:
  • Phone: 760-729-8941
  • Fax:
Mailing address:
  • Phone: 760-729-8941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number71058
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: