Kevin V. Spera, PMHCNS, BC

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

0240982 Issued in CA

Practice address

2300 California St Ste 202
San Francisco, CA 94115

Phone

(415) 600-3503

Fax

(415) 369-1383

NPI assigned

Aug 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1407964638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W EL CAMINO REAL FL 2",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940406203",
            "telephone_number": "415-600-3503",
            "fax_number": "415-369-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 CALIFORNIA ST STE 202",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94115",
            "telephone_number": "415-600-3503",
            "fax_number": "415-369-1383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "822 D St",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949012814",
            "country_code": "US",
            "telephone_number": "202-295-7211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPERA",
        "first_name": "KEVIN",
        "middle_name": "V.",
        "name_prefix": "Mr.",
        "credential": "PMHCNS, BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN95044800",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "PMH586",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "CA",
            "license": "CNS4252",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "CA",
            "license": "0240982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "PMH586",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "CNS4252",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "RN95044800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renee L Spencer, MFT
• Sara Hollister Spencer, M.S. CCC
• Sherry Spencer, M.A., BCBA
• Tiquan Thomas Spencer
• Cathy Spensley
• Sophia Quinn Sperber
• Lawrence Mitchell Spergel, M.D.
• Edra Spevack, N.D., CBHT
• Charles Joseph Spezzano, PH.D.
• Samantha Anne Spiegel Smith, RD

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.