Provider Demographics
NPI:1154577252
Name:SPEARS, CAMBRIA JULIANA POWELL
Entity type:Individual
Prefix:
First Name:CAMBRIA
Middle Name:JULIANA POWELL
Last Name:SPEARS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 E SHAW AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7616
Mailing Address - Country:US
Mailing Address - Phone:559-226-0167
Mailing Address - Fax:559-226-1559
Practice Address - Street 1:83 E SHAW AVE STE 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7616
Practice Address - Country:US
Practice Address - Phone:559-226-0167
Practice Address - Fax:559-226-1559
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA44AZOtherMEDI-CAL PRV NBR