=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629109756
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANET VALDIVIA SPANGLER LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/08/2007
-----------------------------------------------------
Last Update Date | 06/02/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 201 16TH AVE E
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98112-5226
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-326-3000
-----------------------------------------------------
Fax | 206-326-2785
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 808 W 16TH ST
-----------------------------------------------------
City | MERCED
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95340-4600
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-381-6830
-----------------------------------------------------
Fax | 209-383-9666
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 17562
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------