MEDICARE: ROBERT SPERRING LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	53926	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558909200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT SPERRING LMFT

Provider Business Mailing Address
First Line	:	19551 HELENA CIR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92646-3207
Country	:	US
Telephone Number	:	714-968-2427
Fax Number	:

Provider Business Practice Location Address
First Line	:	17111 BEACH BLVD STE 203
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-5978
Country	:	US
Telephone Number	:	714-968-2427
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2019
Last Update Date	:	12/12/2019

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