Provider Demographics
NPI:1851510242
Name:SPICHER, GARY STEVEN (FACT)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:STEVEN
Last Name:SPICHER
Suffix:
Gender:M
Credentials:FACT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:502 BEARDSLEY AVE APT E
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-8013
Mailing Address - Country:US
Mailing Address - Phone:661-326-0485
Mailing Address - Fax:661-326-1455
Practice Address - Street 1:4500 CALIFORNIA AVE STE 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-7030
Practice Address - Country:US
Practice Address - Phone:661-326-0485
Practice Address - Fax:661-326-1455
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)