Provider Demographics
NPI:1194747626
Name:SPENCE, JANE M (LMFT)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:M
Last Name:SPENCE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 BEECHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-5305
Mailing Address - Country:US
Mailing Address - Phone:925-957-9421
Mailing Address - Fax:925-957-9421
Practice Address - Street 1:1611 BEECHWOOD DR
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-5305
Practice Address - Country:US
Practice Address - Phone:925-957-9421
Practice Address - Fax:925-957-9421
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35086106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist