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NPI 1730772690

NPI 1730772690 : NANCY SPEARS MFT : CAMARILLO, CA

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General NPI Number Information
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    NPI Number           |    1730772690
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    Entity Type          |    Individual 
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    Provider Name        |    NANCY SPEARS MFT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/11/2021
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    Last Update Date     |    02/11/2021
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Provider Practice Location Address
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    Address Line         |    360 MOBIL AVE STE 205G 
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    City                 |    CAMARILLO
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    State                |    CA
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    Zip                  |    93010-6373
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    Country              |    US
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    Telephone            |    805-419-6551
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    360 MOBIL AVE STE 205G 
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    City                 |    CAMARILLO
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    State                |    CA
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    Zip                  |    93010-6373
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    Country              |    US
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    Telephone            |    805-419-6551
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    85851
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    License Number State |    CA
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