Provider Demographics
NPI:1598515215
Name:SPARK PSYCHOLOGY, INC.
Entity Type:Organization
Organization Name:SPARK PSYCHOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:RUPA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:408-412-1614
Mailing Address - Street 1:264 N SANTA CRUZ AVE
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-7228
Mailing Address - Country:US
Mailing Address - Phone:408-412-1614
Mailing Address - Fax:
Practice Address - Street 1:264 N SANTA CRUZ AVE
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-7228
Practice Address - Country:US
Practice Address - Phone:408-412-1614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health