Healthcare Provider Details

I. General information

NPI: 1750114195
Provider Name (Legal Business Name): JERAD SPILFOGEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2024
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 MONTEREY SALINAS HWY
SALINAS CA
93908-8820
US

IV. Provider business mailing address

557 LAINE ST APT 1
MONTEREY CA
93940-1361
US

V. Phone/Fax

Practice location:
  • Phone: 831-582-1017
  • Fax:
Mailing address:
  • Phone: 831-241-3078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: