Individual provider Active NPI

Ciprian Raoul Spenser, M.D.

  • Psychiatry Physician
  • Anaheim, CA
National Provider Identifier
1386869493
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A99509 Issued in CA
Practice address
303 W Lincoln Ave Ste 130
Anaheim, CA 92805-2993
Phone
(714) 520-7300
Fax
(714) 520-0883
NPI assigned
Apr 16, 2007
Last updated
Apr 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A99509 CA Primary

Addresses

Primary practice location

303 W Lincoln Ave Ste 130
Anaheim, CA 92805-2993

Mailing address

303 W Lincoln Ave Ste 130
Anaheim, CA 92805-2993
Phone (714) 520-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150519002670 CA Practitioner - Psychiatry 5698851905 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A99509CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Orange Current Accepting new patients
County of Orange CurrentSince Apr 10, 2015 Accepting new patients
County of Orange CurrentSince Apr 10, 2015 Accepting new patients
Stony Brook Psychiatric Associates, University Faculty Practice Corpor Psychiatry PastSince Jul 23, 2015 Accepting new patients
Neurology Associates of Stony Brook, University Faculty Practice Corpo Past Accepting new patients

Locations

303 W Lincoln Ave
Ste 130
Anaheim, CA 92805
Phone (714) 520-7300

23228 Madero
Mission Viejo, CA 92691
Phone (949) 454-3940

14140 Beach Blvd
Ste 223
Westminster, CA 92683
Phone (714) 896-7566

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1386869493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 W LINCOLN AVE STE 130",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928052993",
            "telephone_number": "714-520-7300",
            "fax_number": "714-520-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 W LINCOLN AVE STE 130",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928052993",
            "telephone_number": "714-520-7300",
            "fax_number": "714-520-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENSER",
        "first_name": "CIPRIAN",
        "middle_name": "RAOUL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A99509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.