Doctor Name: | DR. STUART J. SPENDLOVE |
NPI Number: | 1124287800 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | PSY24994 |
Business Practice Address: | 4004 Beyer Blvd San Ysidro, CA - 921732007 |
Business Phone Number: | 6194284463 |
Business Fax Number: | |
Mailing Address: | 4004 Beyer Blvd, SAN YSIDRO |
State: | CA |
Postal Code: | 921732007 |
Phone Number: | 6194284463 |
Fax Number: | |
NPI Enumeration Date: | 06/06/2008 |
NPI Last Update Date: | 04/02/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC2200X |
License Number: | PSY24994 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical Child & Adolescent |
Taxonomy Definition: |