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General NPI Number Information
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NPI Number | 1780213793
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Entity Type | Individual
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Provider Name | ALLEGRA SPALDING
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Gender | Female
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Dates
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Enumeration Date | 04/02/2020
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Last Update Date | 03/12/2024
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Provider Practice Location Address
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Address Line | 5201 GREAT AMERICA PKWY
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City | SANTA CLARA
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State | CA
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Zip | 95054-1122
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Country | US
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Telephone | 323-205-7088
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Fax |
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Provider Business Mailing Address
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Address Line | 9718 1/2 CHARNOCK AVE
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City | LOS ANGELES
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State | CA
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Zip | 90034-3903
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Country | US
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Telephone | 207-294-1908
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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 | 111928
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License Number State | CA
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