Provider Demographics
NPI:1023372109
Name:CRUZ-KATZ, SPENCER JAMES (PHD)
Entity Type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:JAMES
Last Name:CRUZ-KATZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 RAYMOND RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-6013
Mailing Address - Country:US
Mailing Address - Phone:917-324-2762
Mailing Address - Fax:
Practice Address - Street 1:675 PETER JEFFERSON PKWY STE 130
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8618
Practice Address - Country:US
Practice Address - Phone:804-491-8036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-03
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1023372109103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical