Provider Demographics
NPI:1467509091
Name:SPARTA, STEVEN N (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:N
Last Name:SPARTA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 CHILDRENS WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4226
Mailing Address - Country:US
Mailing Address - Phone:858-966-6750
Mailing Address - Fax:858-966-6753
Practice Address - Street 1:3030 CHILDRENS WAY STE 101
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4226
Practice Address - Country:US
Practice Address - Phone:858-966-6750
Practice Address - Fax:858-966-6753
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY6635103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical