Provider Demographics
NPI:1821465915
Name:SPERA, MARION P (MSW)
Entity Type:Individual
Prefix:MS
First Name:MARION
Middle Name:P
Last Name:SPERA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 BIENVILLE ST
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-2901
Mailing Address - Country:US
Mailing Address - Phone:805-729-6047
Mailing Address - Fax:
Practice Address - Street 1:935 BIENVILLE ST
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-2901
Practice Address - Country:US
Practice Address - Phone:805-729-6047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-25
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker