Individual provider Active NPI

Colette Spencer, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Imperial Beach, CA
National Provider Identifier
1922417997
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10058847 Issued in OR
Practice address
506 Sanderling LN
Imperial Beach, CA 91932-2157
Phone
(949) 637-1747
NPI assigned
Aug 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 200843309 OR
Psychiatric/Mental Health Registered Nurse 163WP0808X 0182705 CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10058847 OR Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 678431 CA

Addresses

Primary practice location

506 Sanderling LN
Imperial Beach, CA 91932-2157

Mailing address

1911 Willow Ridge Dr
Vista, CA 92081-7367

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
678431CAMDPsychiatric/Mental Health Registered Nurse
0182705COMDPsychiatric/Mental Health Registered Nurse
200843309ORMDPsychiatric/Mental Health Registered Nurse
10058847ORMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1922417997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 WILLOW RIDGE DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920817367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 SANDERLING LN",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "919322157",
            "telephone_number": "949-637-1747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "COLETTE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": "200843309",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CO",
            "license": "0182705",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10058847",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "678431",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Imperial Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; 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.