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General NPI Number Information
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NPI Number | 1245458702
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Entity Type | Organization
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Legal Business Name | WILLLIAM L SPIVEY PH.D. PSYCHOLOGICAL CORPORATION A PROFES CORP
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 07/03/2014
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Provider Practice Location Address
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Address Line | 2940 SUMMIT ST SUITE 2-A
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City | OAKLAND
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State | CA
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Zip | 94609
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Country | US
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Telephone | 510-893-2001
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Fax | 510-893-2027
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Provider Business Mailing Address
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Address Line | 2940 SUMMIT ST SUITE 2-A
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City | OAKLAND
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State | CA
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Zip | 94609
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Country | US
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Telephone | 510-893-2001
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Fax | 510-893-2027
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Authorized Official
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Title or Position | OWNER PSYCHOLOGIST
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Name | MR. WILLIAM LANE SPIVEY
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Credential | DOCTORATE PHD
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Telephone | 510-893-2001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | ASW11787
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY6159
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License Number State | CA
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