Gerald Randall Speyer, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC 42802 Issued in CA

Practice address

11125 Campus St
Loma Linda, CA 92354-3227

Phone

(909) 558-4570

NPI assigned

Mar 19, 2007

Last updated

Oct 9, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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 PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Marriage & Family Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412812800000",
    "number": "1245354794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11125 CAMPUS ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543227",
            "telephone_number": "909-558-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11125 CAMPUS ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543227",
            "telephone_number": "909-558-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEYER",
        "first_name": "GERALD",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2014-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 42802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MFC 42802",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Destinee Ann Spangler
• Luke Spear
• N. Lennard Specht, M.D.
• Nika Spencer, RN, AGNP CANDIDATE
• Rosemarie Spencer, NNP
• Ronald Spier, DO
• Justin Charles Spooler, M.D.
• Jeremy Dane Sporrong, D.O.
• Jamie L Spotville
• Jennifer Banico Spurgeon, MPT

• Marriage & Family Therapist in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.