Provider Demographics
NPI:1265744635
Name:SPAULDING, PAMELA STARR (MA, MFT)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:STARR
Last Name:SPAULDING
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 BALBOA AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-4818
Mailing Address - Country:US
Mailing Address - Phone:650-922-4426
Mailing Address - Fax:
Practice Address - Street 1:1425 BROADWAY
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3458
Practice Address - Country:US
Practice Address - Phone:650-922-4426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC43316101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health