Healthcare Provider Details

I. General information

NPI: 1811876659
Provider Name (Legal Business Name): JEANINE SPIVEY RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9768 TRIBECA DR
SACRAMENTO CA
95829-9557
US

IV. Provider business mailing address

9768 TRIBECA DR
SACRAMENTO CA
95829-9557
US

V. Phone/Fax

Practice location:
  • Phone: 209-610-6914
  • Fax:
Mailing address:
  • Phone: 209-610-6914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number236660
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number812765
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: