Healthcare Provider Details

I. General information

NPI: 1548809841
Provider Name (Legal Business Name): S P O T, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2020
Last Update Date: 03/22/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 BUENAVENTURA BLVD
REDDING CA
96001-3700
US

IV. Provider business mailing address

1801 BUENAVENTURA BLVD
REDDING CA
96001-3700
US

V. Phone/Fax

Practice location:
  • Phone: 530-215-3385
  • Fax: 818-530-3800
Mailing address:
  • Phone: 530-215-3385
  • Fax: 818-530-3800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUSAN M WALKER
Title or Position: PRESIDENT
Credential: BS OT
Phone: 530-255-4063