Healthcare Provider Details

I. General information

NPI: 1619143641
Provider Name (Legal Business Name): JAMES LIONEL SPIRA PHD, MPH, ABPP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2008
Last Update Date: 05/24/2024
Certification Date: 05/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 13087
OAKLAND CA
94661-0087
US

IV. Provider business mailing address

PO BOX 13087
OAKLAND CA
94661-0087
US

V. Phone/Fax

Practice location:
  • Phone: 808-225-2193
  • Fax:
Mailing address:
  • Phone: 808-225-2193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1332
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number1332
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number34093
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number34093
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: