Healthcare Provider Details

I. General information

NPI: 1609669522
Provider Name (Legal Business Name): RENAE CHRISTINA SPERA FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1647 N CALIFORNIA BLVD
WALNUT CREEK CA
94596-4126
US

IV. Provider business mailing address

1647 N CALIFORNIA BLVD
WALNUT CREEK CA
94596-4126
US

V. Phone/Fax

Practice location:
  • Phone: 925-952-9200
  • Fax:
Mailing address:
  • Phone: 925-952-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95032738
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number732475
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: