Provider Demographics
NPI:1851329205
Name:SPENCE, CATHERINE GAIL (CNM, NP)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:GAIL
Last Name:SPENCE
Suffix:
Gender:F
Credentials:CNM, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4829 CARDIFF BAY DR
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-3414
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2210 MESA DR STE 5
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-3701
Practice Address - Country:US
Practice Address - Phone:760-757-5841
Practice Address - Fax:760-967-4863
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANMW1357367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANMW013570Medicaid
CANMW013570Medicaid
CAWNMW1357AMedicare ID - Type Unspecified