Provider Demographics
NPI:1477442762
Name:SPICER, SHARON
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:SPICER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5225 CANYON CREST DR STE 71-413
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-6301
Mailing Address - Country:US
Mailing Address - Phone:951-901-8105
Mailing Address - Fax:888-909-4209
Practice Address - Street 1:1933 W 11TH ST
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3557
Practice Address - Country:US
Practice Address - Phone:951-682-0088
Practice Address - Fax:888-909-4209
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator