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General NPI Number Information
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NPI Number | 1023372109
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Entity Type | Individual
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Provider Name | SPENCER JAMES CRUZ-KATZ PHD
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Gender | Male
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Dates
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Enumeration Date | 07/03/2012
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Last Update Date | 09/07/2022
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Provider Practice Location Address
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Address Line | 675 PETER JEFFERSON PKWY STE 130
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911-8618
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Country | US
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Telephone | 804-491-8036
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Fax |
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Provider Business Mailing Address
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Address Line | 808 RAYMOND RD
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22902-6013
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Country | US
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Telephone | 917-324-2762
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1023372109
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License Number State | VA
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