Ian Spencer, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMF86857 Issued in CA

Practice address

2610 Industry Way
BLDG., #7
Lynwood, CA 90262-4283

Phone

(213) 807-6515

NPI assigned

May 31, 2016

Last updated

May 31, 2016By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Future Moons

  • Marriage & Family Therapist
  • Los Angeles, CA
  • NPI 1003374356
  NPD (past) Authorized official

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

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1861840837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1614 AVALON ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900261816",
            "telephone_number": "310-600-2037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 INDUSTRY WAY",
            "address_2": "BLDG., #7",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624283",
            "telephone_number": "213-807-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "IAN",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-31",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF86857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yadira Delsocorro Soto
• Southbay Womens Medical Center Inc
• Southern California Health & Rehabilitation Program
• Southern California Health & Rehabilitation Program
• Southern California Health & Rehabilitation Program
• Keshanna Rayann Spencer
• Ryan Matthew Spivak, M.D.
• Jose Spiwak, M.D.
• Dionne Springer
• St Francis Medical Center

• Marriage & Family Therapist in Lynwood, CA
• Providers in Lynwood, 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 May 31, 2016; 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.