| NPI | 1770114662 |
|---|---|
| Doing Business As | SPARK CENTER FOR PSYCHOLOGY |
| Doing Business As | THE SPARK CENTER |
| Doing Business As | SPARK CENTER FOR SELF DEVELOPMENT |
| Entity Type | Organization |
| Authorized Contact | BRENDA VACCARO President 916-616-8561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 103TC0700X Psychologist, Clinical | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2020-01-29 |