Healthcare Provider Details

I. General information

NPI: 1467006411
Provider Name (Legal Business Name): ESTHER SPEARMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2019
Last Update Date: 11/12/2020
Certification Date: 11/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 LINCOLN AVE STE 201
SAN RAFAEL CA
94901-2142
US

IV. Provider business mailing address

116 JAMES RIVER RD
VALLEJO CA
94591-7111
US

V. Phone/Fax

Practice location:
  • Phone: 415-459-5999
  • Fax: 415-459-5602
Mailing address:
  • Phone: 707-334-0717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: