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General NPI Number Information
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NPI Number | 1306284104
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Entity Type | Individual
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Provider Name | TIMOTHY SCOTT SPICER PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 06/13/2013
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Last Update Date | 05/20/2016
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Provider Practice Location Address
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Address Line | 769 W BLAINE ST SUITE B
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City | RIVERSIDE
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State | CA
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Zip | 92507-3970
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Country | US
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Telephone | 646-346-0918
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 17640
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City | ANAHEIM
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State | CA
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Zip | 92817-7640
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Country | US
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Telephone | 646-346-0918
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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