Provider Demographics
NPI:1902384449
Name:SPANGLER, JESSICA R (LMFT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:R
Last Name:SPANGLER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 SHERMAN DR
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-3014
Mailing Address - Country:US
Mailing Address - Phone:619-952-5227
Mailing Address - Fax:
Practice Address - Street 1:332 PINE ST
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-3312
Practice Address - Country:US
Practice Address - Phone:619-952-5227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84499106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist