Provider Demographics
NPI:1790884476
Name:SPENCE, CHERYL RENA (RNFA CNP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:RENA
Last Name:SPENCE
Suffix:
Gender:F
Credentials:RNFA CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4373 CALLE MAPACHE
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012
Mailing Address - Country:US
Mailing Address - Phone:805-444-7110
Mailing Address - Fax:818-886-0200
Practice Address - Street 1:14671 RINALDI ST
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-4199
Practice Address - Country:US
Practice Address - Phone:818-270-9030
Practice Address - Fax:818-270-9039
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15042363LW0102X
CA395822364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health