Provider Demographics
NPI:1255684973
Name:SPOFFORTH, SARAH (MA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SPOFFORTH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 N MAIN ST
Mailing Address - Street 2:SUTIE #1
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-4653
Mailing Address - Country:US
Mailing Address - Phone:925-286-6050
Mailing Address - Fax:925-937-6782
Practice Address - Street 1:1620 N MAIN ST
Practice Address - Street 2:SUTIE #1
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4653
Practice Address - Country:US
Practice Address - Phone:925-286-6050
Practice Address - Fax:925-937-6782
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst