Provider Demographics
NPI:1407020134
Name:SPARTOS, ERICA L (LMFT)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:L
Last Name:SPARTOS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:957 INDUSTRIAL RD STE B
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-4152
Mailing Address - Country:US
Mailing Address - Phone:650-852-6900
Mailing Address - Fax:
Practice Address - Street 1:957 INDUSTRIAL RD STE B
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-4152
Practice Address - Country:US
Practice Address - Phone:650-832-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2016-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81057106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist