Healthcare Provider Details

I. General information

NPI: 1063687481
Provider Name (Legal Business Name): MARK ALLEN SPURLOCK M.F.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2008
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 HILLTOP DR. PMB#411
REDDING CA
96003
US

IV. Provider business mailing address

1095 HILLTOP DR. PMB#411
REDDING CA
96003
US

V. Phone/Fax

Practice location:
  • Phone: 619-813-0315
  • Fax:
Mailing address:
  • Phone: 619-813-0315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 45318
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: