Provider Demographics
NPI:1609127034
Name:SPAGNA, JANET THERESA (PA-C)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:THERESA
Last Name:SPAGNA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7127 HOLLISTER AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-5899
Mailing Address - Country:US
Mailing Address - Phone:805-979-4646
Mailing Address - Fax:805-685-2800
Practice Address - Street 1:7127 HOLLISTER AVE STE 2
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-5899
Practice Address - Country:US
Practice Address - Phone:805-979-4646
Practice Address - Fax:805-685-2800
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA22662OtherMEDICAL BOARD OF CALIFORNIA LICENSE