Active NPI
Nicole Susan Spooner, RDH
- Dental Hygienist
- Clovis, CA
National Provider Identifier
1083155840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 30570
- Practice address
- 2740 Herndon Ave
Clovis, CA 93611-6813 - Phone
- (559) 299-2578
- Fax
- (559) 299-1421
- NPI assigned
- Mar 13, 2017
- Last updated
- Mar 13, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 30570 | CA | Primary |
Addresses
Primary practice location
2740 Herndon Ave
Clovis, CA 93611-6813
Mailing address
2740 Herndon Ave
Clovis, CA 93611-6813
Phone (559) 299-2578
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30570 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489363200000",
"number": "1083155840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2740 HERNDON AVE",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936116813",
"telephone_number": "559-299-2578",
"fax_number": "559-299-1421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2740 HERNDON AVE",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936116813",
"telephone_number": "559-299-2578",
"fax_number": "559-299-1421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPOONER",
"first_name": "NICOLE",
"middle_name": "SUSAN",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-13",
"last_updated": "2017-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "30570",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clovis, CA
- Gilbert Munoz Sosa Jr.
- Jeanette Marie Soto
- Audrey Lynne Spach, LM
- Dennis K Spitzer, PT
- Spitzers Physical Therapy and Personal Training Center, Inc. (Spitzer's Physical Therapy, Inc)
- Kevin Joseph Spruce, DNP, FNP-C
- Sandeep Singh Sran, FNP
- Ranjani Srinivasan, RD
- Vishalakshi Sriram, DDS
- Gregory Lynn Stafford, D.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.