Provider Demographics
NPI:1316798044
Name:SPIRES, RAYFIELD (OTD, MS, OTR/L)
Entity type:Individual
Prefix:
First Name:RAYFIELD
Middle Name:
Last Name:SPIRES
Suffix:
Gender:M
Credentials:OTD, MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8455 LINDLEY AVE APT 210
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-3702
Mailing Address - Country:US
Mailing Address - Phone:207-409-6710
Mailing Address - Fax:
Practice Address - Street 1:8455 LINDLEY AVE APT 210
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-3702
Practice Address - Country:US
Practice Address - Phone:207-409-6710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13331225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist