Andrea Lange Spear, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810007678 Issued in VA

Practice address

417 14TH St
Santa Monica, CA 90402-2131

Phone

(480) 540-5310

NPI assigned

Sep 2, 2015

Last updated

Mar 22, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  DC, Psychologist, TN

  Medicare reassignment NPD
• Goodwill Industries of Santa Clara County

  dba Goodwill of Silicon Valley

  • Community/Behavioral Health Agency
  • San Jose, CA
  • NPI 1750751780
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1205204526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 14TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904022131",
            "telephone_number": "480-540-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 14TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904022131",
            "telephone_number": "480-540-5310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1375 55th St",
            "address_purpose": "LOCATION",
            "city": "Emeryville",
            "state": "CA",
            "postal_code": "946082609",
            "country_code": "US",
            "telephone_number": "510-655-7880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1080 N 7th St",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951124425",
            "country_code": "US",
            "telephone_number": "408-869-9160",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2400 Moorpark Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951282680",
            "country_code": "US",
            "telephone_number": "408-975-2730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPEAR",
        "first_name": "ANDREA",
        "middle_name": "LANGE",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-02",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810007678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sowa Wellness Center Inc
• Kelly Spagnuolo
• Brooke Hansen Spanos, M.D.
• Kathryn Eva Sparks
• Paulina Dianne Speaker
• Special Needs Resource Group
• Jennifer Chen Speckman, LCSW
• Todd J Spector, MD
• Haley Speer, LCSW
• Lin Cheng Speer, LAC, OMD, PHD

• Clinical Psychologist in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.