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General NPI Number Information
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NPI Number | 1407964638
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Entity Type | Individual
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Provider Name | KEVIN V. SPERA PMHCNS, BC
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Gender | Male
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 06/12/2019
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Provider Practice Location Address
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Address Line | 2300 CALIFORNIA ST STE 202
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City | SAN FRANCISCO
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State | CA
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Zip | 94115
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Country | US
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Telephone | 415-600-3503
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Fax | 415-369-1383
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Provider Business Mailing Address
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Address Line | 2350 W EL CAMINO REAL FL 2
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-6203
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Country | US
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Telephone | 415-600-3503
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Fax | 415-369-1383
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN95044800
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | PMH586
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | CNS4252
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 0240982
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License Number State | CA
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