Healthcare Provider Details

I. General information

NPI: 1063326684
Provider Name (Legal Business Name): ERIK J COX SPANN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 W SHAW AVE STE 101
FRESNO CA
93711-3334
US

IV. Provider business mailing address

2117 W PRINCETON AVE
FRESNO CA
93705-3620
US

V. Phone/Fax

Practice location:
  • Phone: 559-681-3161
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: