Provider Demographics
NPI:1609256437
Name:SPENCER, ZANI
Entity Type:Individual
Prefix:
First Name:ZANI
Middle Name:
Last Name:SPENCER
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 1:827 E 154TH ST
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90220-2500
Mailing Address - Country:US
Mailing Address - Phone:855-246-9663
Mailing Address - Fax:855-246-9663
Practice Address - Street 1:827 E 154TH ST
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-2500
Practice Address - Country:US
Practice Address - Phone:855-246-9663
Practice Address - Fax:855-246-9663
Is Sole Proprietor?:No
Enumeration Date:2015-06-06
Last Update Date:2015-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver