Provider Demographics
NPI:1699364414
Name:SOCIAL SPARK CONSULTING
Entity Type:Organization
Organization Name:SOCIAL SPARK CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/BCBA
Authorized Official - Prefix:
Authorized Official - First Name:DANIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSKWA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:650-224-5485
Mailing Address - Street 1:6039 FOOTHILL GLEN DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-4508
Mailing Address - Country:US
Mailing Address - Phone:650-224-5485
Mailing Address - Fax:
Practice Address - Street 1:6039 FOOTHILL GLEN DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-4508
Practice Address - Country:US
Practice Address - Phone:650-224-5485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty